Is there a size limit to under the muscle implants? 34AA, Athletic, 5'8', 70kg, no kids (Photos)

Currently 34AA, wanting to go to a full D. Under muscle as tubular limited tissue. I have seen 3 plastic surgeons, i want to be a full D. Or as a near as poss. I have had 3 different reviews - 370cc HP saline unders for 'C' cup but doctor said i have limited breast tissue. - 425cc HP saline unders for a 'D' - 425 - 450cc HP saline unders Based on photographs, any advice, obviously measurements and in person consultations are needed, just curious.

Doctor Answers 13

The right size for you?

It is very difficult to determine the best lift you will need (recommended based on your photos) or 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 300 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. The same process goes for just filling in the upper part of your breast without becoming much larger. 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 as I will further explain in the link below including silicone vs saline implants

Is there a size limit to under the muscle implants? 34AA, Athletic, 5'8', 70kg, no kids (Photos)

Smooth round silicone implants under the muscle is best. Size will depend on the measurement of your breast base width which should match the base width of the implant. You may need scoring of the constricted breast tisue on the right.

Breast implants

If you are 22 or older, I would recommend extra high profile or higher filled gels. That would allow a larger cc size for your small frame measurements.

An exam and consultation with a plastic surgeon who performs these procedures is recommended to confirm you are a candidate as well as discuss your options and expectations.

Implant Size

Implant size selection is the most common question for breast augmentation patients.  In terms of picking the right implants to achieve your goals, generally speaking, I consider two factors when selecting implants for my patients:

1. Dimensional planning and 2. Gel Implant Sizing system

Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall.  Hence a physical exam is really needed to give you any meaningful advice.  

Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural  fuller look. Hope this helps.

Dr. Basu
Houston, TX

Is there a size limit to under the muscle implants?

Anatomically, there are indeed limits on maximum implant size, though we have all seen women and surgeons who push the limits of what most would consider appropriate or proportionate. Most ABPS-certified plastic surgeons with extensive experience in breast augmentation will be able to give you good advice, and you have done well to consider three different recommendations. I'm OK with big, but in women with your anatomy, "as big as reasonably possible" would be my recommendation.

Based on your goals, I agree that HP implants will be required to achieve the size you wish. However, because you have very little of your own breast tissue or fat with which to "cover" your implants, I believe saline is a poor recommendation. Not only can they leak and deflate, but rippling is more likely, giving two avoidable reasons for re-operation. Submuscular is definitely recommended, but will not suffice to allow saline as a "best recommendation" IMHO. 

I'd see a few more surgeons in consultation--saline implants were "fine" when the FDA mandated their use between 1991 and 2006. Over 85% of plastic surgeons now recommend and use cohesive silicone implants, especially with anatomy such as yours, making the 3 surgeons you have seen thus far in the definite and distinct minority.

Also, you do not have "tubular" breasts--they are simply small with widely-spaced nipple/areola complexes. You are a perfectly fine candidate for breast augmentation. For more information, please read my Comprehensive Guide to Breast Augmentation by clicking on the web reference link below. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 240 reviews

Is there a size limit to under the muscle implants?

There is a limit which is often determined by chest size and breast width, and the tightness of the breast fold. The implant must fit into the envelope or footprint of the breast to get a good marriage of the two.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.1 out of 5 stars 40 reviews

Is there a size limit to under the muscle implants? 34AA,

Thank you for your photo and questions. There is definitely a limit to one's capacity to accept a large implant when you have limited skin, breast tissue and especially limited skin between your breast crease and your nipple.  Forcing a large implant in place increases the risk of a double bubble and other deformities or implant displacement.  My recommendation would be to set your sights on a more conservative goal and after one to two years consider revision surgery to place a noticeably larger implant at that time.  I think that that is a safer and proper course to consider starting from a AA cup.  Make sure to get a few opinions before proceeding,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Implant limitations

It really depends upon your anatomy and how tight your tissues are.   Best of luck with your decision to move forward.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Implant selection

Hello and thank you for your question. You are a great candidate for a breast augmentation.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 80 reviews

Correct Implant Size?

Based on your pictures, it does appear that your own tissues will be the limiting factor in the size of the implant.  A HP implant will provide the projection for improving the shape, but the size is really based more on measurements.  I would caution on the use of saline implants though.  When you are thin and have little breast tissue of your own, there is a higher chance of rippling issues with a saline device.  I hope this helps.

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.