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

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.

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

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

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

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.

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. It appears you would benefit from an implant in the 400cc - 425cc range to achieve your desired results. 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 breast surgery. Hope this helps and good luck with your surgery.

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



#RealSelf100Surgeon



#RealSelfCORESurgeon

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

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.

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