I want a full D - Is 365cc too large for me? (photo)

Question

I'm currently at a 36c. I want a full D. I had 2 consulations. 1 said lift first then 1 year later come back for implants no larger than 300cc. 2nd surgeon said lift and implants could easily be achieved. He suggested 240-310cc moderate profile. I feel with a lift that wouldn't be much larger. I feel 365cc full profile would be better considering tissue is removed during lift. Would that be too large with a lift? Scheduled in 1 month for surgery. 5"5 150 lbs 36 years old

Casey Anderson, MD, FACS · Answer

In these situations, it's important to listen to what your surgeon is saying. If you are not on the same page, try to iterate your concerns so they can be answered appropriately. From your digital image, it is reasonable to do the lift an implant at the same time. As for size, that is a matter of preference.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Vasileios Vasilakis, MD, FACS · Answer

Hello, implant sizing is a very detailed process that requires in-person assessment and evaluation. You should trust the judgement of your surgeon, especially since you have already booked your surgery. I wish you the best of luck. Vasileios Vasilakis, MD. Double board-certified, fellowship-trained plastic surgeon, Houston. TX.

Gary M. Horndeski, MD · Answer

At size 36, each 200 cc of implant corresponds to 1 cup size change. To go from a C to a D would require 200 cc implants. Also, the photos you have shown show a lift technique with the vertical scar. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear CodysBabe,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

The best range of sizes for your tissue and frame is determined by measurements and an examination. Both surgeons did not appear to recommend 365, so it may be too large for you.  I would go back and discuss size again with the surgeon you selected, and try on those sizes as well.

Darryl J. Blinski, MD · Answer

In cases as yours the patient desires a lift along with larger implants. Those 2 can not be accomplish in 1 operation. Because the vertical incision if under to much internal pressure from larger implant will split open! Best to stage the operations. First a lift with 4-6 month healing. Then larger implants to achieve a D cup, in the 450-550 cc ranges.

Jeffrey C. Hamm, MD - Account Suspended · Answer

Hi and welcome to our forum!
From the computer generated photos, I note that the distance from the top of the breast bone to the nipples is increased, and the distance from the nipple to the fold beneath the breasts is also increased. The nipples reside at the level of the fold beneath the breasts and there is moderate sag.
During pregnancy or following significant weight fluctuation, breast enlargement may lead to overstretching of the overlying skin. The skin thins and permanently stretches to accommodate the increased volume, but after childbirth or weight management the breast loses volume, but the damaged skin envelope does not shrink, leading to sag. Visible stretch marks often indicate the severity of the overstretching. Some individuals may demonstrate sag without previous pregnancy or weight fluctuation.
During the breast lift procedure, only stretched out skin is removed. Breast tissue is not manipulated. However, the breast may appear somewhat smaller due to the change of shape. A surgical breast lift will place the nipple areolar complexes into their anatomic positions, will conify the shape of the breasts, and will remove the excess stretched out skin. 
The difference between 300 cc and 365 cc is 65 cc, less than 2 shot glasses....not much difference in final size. The choice of size is totally subjective.
Depending upon your medical health and tightness of overlying skin / soft tissues, the procedures can be performed concomitantly or split into two separate surgeries...I would trust the decision of a board certified plastic surgeon.
Best wishes...

I want a full D - Is 365cc too large for me? (photo)

Answers (8)

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