Are 300cc Silicone Implants Under the Muscle going to be too large with very little breast tissue?

Question

A very small AA cup (basically nothing) to a small C cup. The surgeon took my measurements and felt the tissue, said between a 300 cc - 350 cc would take me to a C cup. After trying the different sizes on with another consultant, I preferred the smallest - 300cc on my frame. After doing further research online I am worried that my little breast tissue wont be enough to hold the implant and the rippling will be obvious. What is the likelihood of this & what profile would you recommend? Thanks!

Keith Hodge, MD · Answer

If you are a AA cup, 300cc's will look larger on you that the average woman. Earlier this week, I placed 210cc implants in a petite 110lb woman, and she is thrilled. So if you tried them on, and they aren't too wide, you should look very good. I am using the new Inspira implants so there is less risk of wrinkling and rippling. These implants have a higher gel to shell ratio so they are very smooth, just something to consider. Best of luck!

John L. Burns Jr., MD · Answer

I prefer a textured anatomic style implant such as the Allergan 410.  The shaped implant will look more natural on your smaller body type.  I recommend using 3D imaging to see what size you would prefer.  Anatomic style implants are best place through an IMF incision and under the muscle.

Carolina Restrepo, MD · Answer

If you are thin with small breasts the key is to fill out the upper and lower parts of the breast with the right implant and to place it in a way that looks relatively natural. The technique that best achieves this is a Dual plane technique, where the implant is below the muscle in the superior pole of the breast, and the lower portion of the muscle is released to allow the implant to fill the lower pole of the breast. This covers the implant sufficiently while allowing it to be in an ideal position and fill the breast envelope beautifully.The common denominator to the most beautiful breasts is that they were sized objectively on the basis of measurements. For instance, we combine a proven formula based on measurements of the rests and chest along with through discussions of patient's desires. If you are worried about rippling, gummy bear implants are best. They have a very soft natural feel and they don't ripple as much as saline implants.

Plastic surgeons are trained differently and have varying levels of experience and so the key is to work with a Board Certified plastic surgeon with expertise and experience in breast augmentation. He or she should be able to clearly explain their approach and why they do things a certain way. I hope this was helpful.

Plastic surgeons are trained differently and have varying levels of experience and so the key is to work with a Board Certified plastic surgeon with expertise and experience in breast augmentation. He or she should be able to clearly explain their approach and why they do things a certain way.               I hope this was helpful.

Paul W. Papillion, MD · Answer

Hello, 300 cc sounds like a very reasonable choice. An examination would be the best way to comment on your tissues. Choosing a Gel implant and going under the muscle would be a good option to decrease the risk of rippling. Good luck.

Robert L. Steely, MD, FACS · Answer

Good morning!These questions are always hard to say without an exam- but speaking in broad generalities, a petite woman with minimal breast tissue usually do well with implants in that size range under the muscle.I would discuss your concern with your PS or consider a second opinion.I hope this helps.

M. Scott Haydon, MD · Answer

Thanks for your question. It's hard to give accurate advice without examining you or reviewing pictures. It sounds like you have had good discussions. I don't think 300CC is an overwhelming volume especially if you have a breast base diameter of around 12cm. Even though you might have a small amount of breast tissue, it the silicone implant is placed beneath the muscle it should be ok. Best of Luck!

Elena Prousskaia Peregudova, FRCS (Plast) · Answer

Hi,Thank you for your question. Your concern is reasonable.300 cc can give you a nice result and the final adjustments on the volume can be done on the op table using sizers. I personally find it very useful if i need to decide if i can give the patient 50 cc more or not.You are right, in thin patients there is a higher risk of slightly more visible and palpable implant, especially in infero-lateral pole, but most of the patients are very happy with their results. It is a bit difficult to advice you on profile without seeing your photos. I use anatomical MF a lot, but it highly depends on the measurements and body type.I hope that helps.Good luck with your surgery.Best wishes.Elena Prousskaia

Bryan Correa, MD · Answer

It is difficult to say accurately without an exam, but most patients have some palpability of the implant on the bottom outer part of the breast, and if rippling occurs it is usually here but not overly noticeable. I hope this helps

Tom J. Pousti, MD · Answer

Thank you for the questions. Unfortunately, online consultants will not be able to provide you with specific enough advice to be truly helpful. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C cup” or "too large" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, one in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Troy A. Pittman, MD, FACS · Answer

In patients like yourself that are lacking in overall breast tissue, placement of the implant is key.  I would recommend total-muscle coverage for the implant.  In the upper-pole, the muscle will mask the upper border of the implant.  This will prevent or minimize rippling.  In the lower-pole, leaving the muscle attached will provide extra support for the implant and prevent palpating the implant in the bottom of the breast.  Although a 300-350cc implant does not sound unreasonable in your case, it is important to look at the base width of the implant.  In this size range, the width of the implant can vary by as much as 2cm.  If the implant is too wide, you will be able to feel the implant laterally.  It's important to go with an implant that is narrower than your current breast-base width.