I am currently a 32B (on the smaller side), 375cc silicone high profile or 400cc high profile? (photo)

Emily,
You have slightly ptotic breasts and I would recommend the highest profile implant possible in order to give you an uplift. 

I appreciate your question!

After performing hundreds of breast augmentations, I have found that 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. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.

Silicone will give you 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 softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured.

Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, is 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. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.

We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.

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

The average breast implant in the US is 350 cc.  Typically you will not notice a significant different between breast implant sizes unless they increase by 100 cc's.  You still have time to revisit your PS and try on sizers to determine if there is any noticeable difference between the 375cc and 400cc.  Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Please note that implant cc's do not represent cup size post op as different bra manufacturers vary with their product. I recommend speaking to your surgeon again to re-discuss your options with your desired look.Regards,

Hi Emilyh93,When your surgeon said a measurement of 12 this is most likely referring to the width of your bust which would determine how big of an implant you would be able to have. It is important to remember that different sized implants will look different on different types of people as it all depends on the breast tissue and frame of the person. I usually order a couple of different sized implants and use an implant sizer during surgery to see which implant fits you best. It would be worth speaking with your surgeon to see if it would be possible to do something similar if this is not already planned.If you are feeling unsure about your decisions it is always best to speak to someone as soon as possible as you do not want to regret it after the operation. Maybe see if you could have an additional sizing appointment before your procedure to try out the larger sized implants. Wishing you all the best with your upcoming operation.

A difference of 25cc's is very small. It is less than two tablespoons. In my practice during surgery I try different size implants, and see how the breast looks in the sitting upright position, to determine the best size implant for my patient, the size that gives the best shaped breast, not a particular cup size. A consultation with an experienced Board Certified Plastic Surgeon will be able to determine what is best for you.

Hi emilyh93.  Thank you fo ryour question and photos.  Congratulations on your decision to have breast augmentation.  The size you choose is determined by your own goals and your anatomy/measurements.  Roughly a 375cc with your size would give you about 3 cup sizes fuller - so full D / DD.  Depending on your measurements - you may be able to have the 400cc.  I use the Crisalix 3D imaging at my consultations to best simulate the results my patients are hoping to achieve.  Ask your surgeons offce for the measurements of the 2 implant sizes so that you can relate these to you own body measurement.  Good luck

Dear Emily, 
Congartulations on your decision. The answer to what size suits you best should be based on certain measurements of your breast anatomy and skin envelop. Such tissue based planing has shown significant decrease in the rate of complications and redo procedures in several studies. Besides, going to the larger side might by itself carry certain risks that occur in patients with large breasts. So you need to study your decision very carefully before you commit to any size.
Best,
Shady Hayek

Thank you for the question. 
 Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.
There are several steps taken to select a specific size/profile breast implant for a specific patient. These steps will vary from one practice to another.  I prefer to have a wide selection of implants (all profiles) available in the operating room. I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. 
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, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) 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 "DD cup” 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, 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.
***In your case, my best advice: more communication. It will definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.
I hope this helps. Best wishes for an outcome that you will be very pleased with. 

Congratulations on your plan to have a breast augmentation.  Your very nice breast anatomy and should achieve a very nice result with a high profile breast implant.A 375 cc is appropriate for your base width.  Discussed with your surgeon whether ultra high profile implants of a larger volume would be appropriate.  A double D bra cup size would likely require a larger implant.