I'm stuck between 457-475 cc hp round silicone implants. How many cc's should I go with? (photos)

Question

I am 5'2, ~108lbs, currently a 30b and was hoping for (what would be equivalent to) a very full D to DD. I had a consultation using the vectors 3D imaging machine and am stuck between 457-475cc hp round implants, preferably silicone but am on a budget of $4000 or less so may need to do saline instead. I was curious if I could get some input or suggestions on what would work best. Also as far as pricing, if anyone knows a facility or ps that works with my lower budget. Thank you. :)

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The size of implant is dictated by your
chest wall measurements.  Once we determine that we can choose the profile
based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.

Silicone will give you a fullness at the
top (upper pole fullness).

Silicone implants come pre-filled with a
silicone gel and are the softest implant available. They feel more natural,
which makes them a good option for women with less natural breast tissue; but
they require a larger incision. It may be more difficult to realize if this
type of implant has ruptured, so it is important to monitor them with annual
follow-up visits. Additionally, because this implant contains a more liquid
silicone (less cross-linked), if this implant should rupture, it will leak only
into the scar capsule formed around the implant but may cause some discomfort
or implant distortion.

Anatomic gummy bear implants might be a
good choice to give you volume.

These highly-sought-after, anatomic
implants offer a look that more closely resembles the natural silhouette of a
breast, and, therefore, are a very attractive option for individuals seeking a
natural-looking, aesthetic primary breast augmentation. Additionally, these
implants are an especially excellent option for patients undergoing restorative
or corrective breast surgery because they provide more stability, shape, and
reduced incidence of capsular contracture. Compared to other types of silicone gel
implants, the silicone in the cohesive gel implant is more cross-linked;
therefore, should the implant shell “rupture,” it maintains its shape and
silicone does not leak.

During your breast augmentation
consultation, you should feel the different types of implants available, and
try on various implant sizers in front of a mirror to help you to get an idea
of how you will look following the surgery. You should also bring pictures of
the look you would like to achieve, as well as a favorite top to wear when
trying on implant sizers.

The best way to assess and give true
advice would be an in-person exam.

Please see a board-certified plastic
surgeon that specializes in aesthetic and restorative breast surgery.Best of luck!

Dr. Schwartz

Board
Certified Plastic Surgeon

Director-Beverly
Hills Breast and Body Institute

#RealSelf100Surgeon

Jose M. Soler-Baillo, MD, MS · Answer

Thank you for your question and photos.  The range of implant sizes that you are considering is not large enough to make a significant difference.  What will make a difference though, is the profile of implant that you choose.  Your breasts are wide set, meaning that you need to understand that the gap between your breasts cannot be shortened without distorting your breasts.All the best,Dr. ResultsMiami, FL

Martin Jugenburg, MD · Answer

The difference between 457 and 475 is so minor that it will not likley visibly show any difference in size. Regards,

Robert Kearney, MD, FACS · Answer

A shot of tequila is 45cc - the difference in those two implants is less than 25cc.  If you want to be the biggest you can do then use the 475. The difference is really no difference.

Gerald Minniti, MD, FACS · Answer

Hello,There is almost no difference between the two sizes. There is no way to guarantee a cup size, as there is no reliable formula between cup sizes and implant volume. The most important factor to prevent post operative complications that lead to re-operation is biodimensional planning to determine an appropriate sized implant to match your soft tissue capacity. If you find a surgeon to get you to look like your wish pics, you'll have virtually no soft tissue coverage over the medial aspects of the implants, and you will have significant rippling, especially with saline implants.  Keep in mind that you want a good result not just in the immediate future after your surgery, but for years to come. Your budget is far below any ABPS certified/ASAPS member surgeons' fees.  In fact, your budget is below most surgeons' fees that perform breast augmentation, including most of the non-core doctors that unfortunately perform this surgery, including ENTs and Ob/Gyns.  Time and again a corollary has been demonstrated between low prices and high complication rates. You would be wise to wait until you can afford the average cost of breast augmentation performed by core surgeons. Best of luck!

Jonathan Saunders, MD · Answer

you are sweating about  an insignificant amount of saline.  18 cc is a little more than a tablespoon. I would suggest gel though. you will have softer more natural breasts and less rippling in someone as petite as you. the extra expense will be worth it in the long run.

Malcolm A. Lesavoy, MD, FACS · Answer

The difference in 457 and 475 is not significant and will not make much difference in your shape.  Definitely leave it up to your surgeon to determine the size at the time of surgery, as most of us do.

Robert Singer, MD · Answer

The best cosmetic result in any particular breast
augmentation patient depends on a variety of factors, including: Your
individual anatomy, desired outcome, realistic expectations, a thorough
discussion with the plastic surgeon about the options, and an understanding of
the pros and cons of any particular implant choice. Proper sizing is not just
about the number of cc’s. The thickness of your tissue, breast dimensions which
include the width, height, and projection, as well as chest wall width all need
to be considered when choosing an implant. Trying on implant “sizers” of
various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit
at a preoperative visit will help you and your surgeon choose the optimal
implant.
There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 32 D-DD and a 38 D-DD are significantly different. Cup size varies from
manufacturer to manufacturer and even within styles from any particular
manufacturer. There is also no direct correlation between an implant size or
shape and resultant cup size.There is very little difference in the cosmetic result between a 457 and a 475 cc. implant.
Keep in mind that following the advice from a surgeon on this or any other
website who proposes to tell you exactly what to do without examining you,
physically feeling the tissue, assessing your desired outcome, taking a full
medical history, and discussing the pros and cons of each operative procedure
would not be in your best interest. I would suggest that your plastic surgeon
be certified by the American Board of Plastic Surgery and ideally a member of
the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and
are comfortable with. You should discuss your concerns with that surgeon in
person.
Robert Singer, MD FACS
La Jolla, California

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.  Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "D or DD cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Jeffrey K. Scott, MD · Answer

It is not possible to give accurate advise without an actual physical examination and biodementional measurements of your breasts and chest.  However based on your petite build and a "30 B" current bra size, it may not be  possible to actually place implants of that 457-475cc range within your breasts. Having said that, there is very little difference in appearance between these 2 sizes. Choose your surgeon based on reputation, credentials and ability, not on cost alone.

I'm stuck between 457-475 cc hp round silicone implants. How many cc's should I go with? (photos)

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