Should I stick with 270cc or should I aim higher? (photos)

I appreciate your question.

The size of implant best for you 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

Hi AB,You have a small frame, and I think you are on the right track.  But, yes, most people wish they were bigger down the road.  Here are a few tips for you because this is perhaps
the hardest decision for a patient to make, as well as the surgeon. Also see the video attached to my answer. We spend up to two hours for our BA consults
to be sure there is careful communication. We do a full exam in front of a
full-length mirror taking six exact measurements.We put your photos on a large computer screen
for imaging, and go over your “ideal-size” photos. We then save this
information to your password protected “web account.” First and
foremost the implant should fit the dimensions of your breast and tissue cover.
Balancing the implant to your
over-all body shape and tissue cover is essential.The main thing is to have the diameter of the implant fit the diameter of
your breast "foot print". The average
size chosen over our last 7,000 breast implants was “350cc”.BUT, 90% of our patients tell us they wish they were bigger a year after
BA.(We will see you every year for
routine checks at no charge.) It’s like your mind incorporates the "new
you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
You can try on implants in the office by
placing them into a special bra.The implant is also flattened
somewhat when under the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket. Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues.Multiple measurements need to
be taken to fit an implant to your exact anatomy. Have your surgeon's office
show you the charts of the implant dimensions for the various profiles of
silicone and saline from the manufacturer. Then you and your surgeon can
piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan.Keep in mind
larger implants tend to have more problems over the years.Since silicone implants wrinkle less than saline
implants, they might be your best bet.You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra.Wear this around the house for a while, and
see what you think.Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
Multiple measurements of your chest wall
are taken (seven in total). Implant size
selection has been an issue of much discussion. Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape. A photo album of patient
pictures is maintained to assist them. These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery. In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover.Finally,
your verbal requests are factored into the analysis. We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals.It is a surgical procedure that
uses special instruments and techniques to minimize tissue damage and avoid
touching the ribs. It causes far less trauma to surrounding tissue than traditional
approaches, and it dramatically reduces pain and recovery time. In published
studies of BA patients, 95-percent of women interviewed after the procedure
returned to normal daily activities within 24-hours. Quick-recovery BA is not a
“gimmick.”These specialized techniques,
which actually speed recovery and get you back to your daily routine, kids and
work, are published in our plastic surgery journals.Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons). Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year. Be sure the PS has been in practice for a
while, about 20-years might be a good gauge.Does the PS offer all three incisions?Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach."Ask to see their before and after photos if you didn’t see any on their
website. If they are experienced, they should have several 100 breast
implant patients for you to view. I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you. You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center. Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.All the best, “Dr. Joe”