I'm 5'5, weigh 125/130lbs & a 34A. My BA is scheduled for July 15th. What should I do?

I'm overwhelmed because my Dr. Is not sure what size implant will fit. He will have 2 sizes at the time of surgery. 350cc & 375cc! Both are smaller than what I had hoped for:( The surgery is already paid for, so my question is...what can I do besides go to another Dr.?

Doctor Answers 16

Breast augmentation

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I recommend finding some photos of your desired post op appearance (I usually recommend a web site like implantinfo.com) and then meeting with your plastic surgeon again to see if the size of implants he/she has chosen will give you your desired results.

Good luck,

Dr. Luong

Edina Plastic Surgeon

Choosing implant size

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It is very important that you feel comfortable and confident in your choice of surgeon. That said, it is common to have several sizes of implants available and make a final determination in the operating room. I would recommend that you make an appointment as soon as possible with your chosen surgeon to discuss your concerns and expectations. It may be helpful to bring photos of breasts you find attractive on girls with a similar body type to yours.

Although it is impossible to say without measuring your chest wall and assessing your breasts, for most patients of your height and weight a 350 or 375cc implant will produce a significant increase in size. Please keep in mind that larger implants have more problems long term. Talk to your surgeon about why he or she is recommending this size for you. 

Best wishes, Dr. Meghan Nadeau, Seattle, WA

Meghan Nadeau, MD
Seattle Plastic Surgeon

Picking the Right Size Implant

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It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon.

Implant Size Suitable for Your Body and Frame

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Factors which contribute to the outcome of Breast Augmentation are #size, #shape, and #profile.
The #profile is determined by the amount of #projection versus roundness that the you desire, as well as the #size of the implant and size of your chest. Also, the placement or incision location will also have an effect on profile.
This may also provide some insight. If a woman wears a size 36 AB bra and would like to be a C cup, which is the average size that women wear and the average size bra that is sold, she needs a volume of approximately 350 to 390 cc to make that change. This becomes less if she's wearing a 34 bra, because it has a smaller strap size and the cups have a smaller diameter. A smaller diameter implant would then be a volume of approximately 300 to 350 cc. In the same way if she was more petite, maybe a double zero or size one and wore a 32 AB bra, then to become a 32C cup she would only require about 250 to 300 cc. The profile is determined by the amount of projection versus roundness that the you desire, as well as the size of the implant and size of your chest. As much as it's important to know what size bra you currently wear, the strap size is important to know as well. It affects the diameter of the cup and subsequently the diameter of the #breast implant that you choose. In my practice, about 15-20% of the patients are good candidates for silicone #shapedimplants.
#Subpectoral or #submuscular implants refer to placement under the muscle which still remains the most common placement in the United States. #Submammary or #subglandular implants are the placement under the breast tissue in front of the muscle. This tends to more common in Europe and South America. General guidelines suggest that women with larger drooping (ptosis) breasts that do not want a breast lift often have the implant placed above the muscle, although another option, #DualPlane, has become more popular. In the Dual Plane method, the implant is placed under the pectoralis muscle but the breast tissue is also release, in part, from the muscle. Those patients with minimal breast tissue should usually have the implant placed beneath the pectoralis muscle for more soft tissue padding.
Your Plastic Surgeon will measure you to determine the best shape, size and placement of the #implants to be used. Lastly, another important element to a satisfying result of your #augmentation is realistic #expectations.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Let's talk...

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You should talk to your surgeon as soon as possible so that there are no misunderstandings regarding implant selection. He/she has determined your implant size based upon your breast / chest dimensions and your aesthetic goals. Please make the call; it's not too late. 

What should I do?

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Thank you for sharing your question.  Without an in-person examination it is impossible to offer definite advice, but I would advise you to speak with your surgeon further about your anticipated augmentation as you both should be on the same page when it comes to your goal results.  It sounds as if clarification of implant sizing needs to take place so that you can be confidant in the sizing decisions.  Best wishes.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Make sure you are comfortable with your surgeon, first and foremost

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Make sure that you trust your surgeon to do what is right for you.  It sounds like they have considered the issue of implant sizing and as such are bringing two options.  With that said you should probably see them again as you still have concerns. 

Cosmetic surgery should be a time of excitement and anticipation, not worry.  I spend a lot of time over 2 or more visits with my patients to be able to explain the surgery and expected outcome as well as describing the recovery as best I can.  I take time and use 4 different techniques to pick the perfect implant to match my patients goals.  If there is any concern I see them again prior to surgery.  I think this really helps patients to feel comfortable and to do the best I can to always match the breasts that my patients want. Surgery should be fun for everyone.  See your surgeon so they can set you at ease.

Dr Rodger Shortt
Oakville Plastic Surgeon

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 85 reviews

Breast Implants/ Breast Augmentation/ Anatomic Gummy Bear Implants/ Silicone Implants/ Breast Implant Revision Surgery

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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
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute

Implant choice

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Depending upon what you look like, your doctor may be right that a larger implant would not be possible. I could not say without an exam.  Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Unhappy with breast implant size surgeon recommends before breast augmentation surgery?

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Thank you for asking this important question.  My advice to you is to immediately communicate your dissatisfaction with the implants your Plastic Surgeon has chosen by calling the office and setting up another preoperative meeting with your surgeon.  Do not go through surgery without this issue being resolved -- that is bad for both your and your surgeon, and he/she should be keenly aware of this.  Explain clearly that you want bigger implants.  And then make your surgeon explain why he or she is refusing.

This is your body, and the size of implant you want is ultimately your final decision.  Your surgeon is there to perform your surgery safely and recommend implants that would be way too small or way too big for your frame, but I would doubt that going into the 400cc+ range would be a problem for you.  In my practice I use an implant sizing system that can really give an accurate idea to my patients.  They try on various sized breast-shaped sizers and they can look in the mirror and decide what they like best.  

If the surgery is already paid for, no problem as long as you are happy with your surgeon and you have made it clear the size you want.  If you meet with your surgeon and you are still having a problem getting the size implant you want, then my advice is to determine your surgeon's refund policy and cancel your surgery as soon as possible to avoid losing a significant amount of what you have paid.  Do not have a breast augmentation with a Plastic Surgeon who refuses to respect your wishes -- you will ultimately be unhappy and end up having another surgery to increase your implant size sooner than you think, which is just a giant waste of your money.  Do it right the first time with a Plastic Surgeon you can trust to help you achieve your goals.

Best of luck!!!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.