280cc or 300 cc? (photos)

Question

Weight 40 Kg, I measure 1.54cm and my chest is 68 cm. Hello, my doctor had told me that I could get from 280 to 300 cc, when I looked at pictures and everything said I want a 325cc or 300cc. But today I went to consultation to decide my final measure, 240cc, 280cc and 300cc. The CC in the photo is 280cc. I was thinking about choosing that, I feel somewhat hesitant between 300cc and 280cc, because I do not want to see something exaggerated in my body that this little Thank you!!!

Donovan Rosas, MD · Answer

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. This will ensure that you avoid the dreaded "fake" look. 
The question of "too big" or "large enough" is a relative question. The safest approach is to stay within the boundaries of your BWD. Beyond that, the choice is yours. Without measures, it is difficult to offer more concrete advice than that. 
I would not stress over a 20 cc differential as this will have a subtle affect on outcome (20 cc is less than half the volume of a shot glass or 4 teaspoons). 
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Payman Danielpour, MD, FACS · Answer

I routinely perform a Vectra 3-d simulation for all of my breast augmentation patients in order to take the guessing game out of breast implant based surgery.  The Vectra 3-d simulation machine takes a picture of YOUR breasts and allows a thorough consultation to be performed showing YOU, the patient, exactly what different implant sizes, shapes, profiles and manufacturers look like on your body.  The simulation will point out any and all asymmetries and give you a chance to pick the size and profile of your implants after you see what they look like on YOUR body.
I highly recommend that ALL breast augmentation patients have this done prior to picking a size for their breast augmentation.

Daniel Barrett, MD · Answer

Dear violetars,Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 
  
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
 Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
 Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
 You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Tim Sayed, MD, MBA, FACS · Answer

The difference between the 280 and 300 cc implants should be pretty hard to discern and in that case I usually recommend going with the larger implant (assuming your base diameter can accommodate it). It is less common to request reoperation to go smaller than it is to request upsizing, so two implant volumes close in cc's should usually prompt the patient to go with the slightly larger one. I use Crisalix simulation along with sizing kits and wish photos to help take the guesswork out and allow the patient to visualize prospective results in more than one manner for a more educated decision.

Tom J. Pousti, MD · Answer

My best advice: more communication.
It is 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.
One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?
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 "C or D cup” or "exaggerated" etc may mean 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.
I hope this helps. Best wishes for an outcome that you will be very pleased with.

Jon A. Perlman, MD (retired) · Answer

Each of us has a technique that we are comfortable with in choosing a final implant size.  Some doctors prefer to use measurements and preselect an implant and others like myself prefer to insert a test implant called a sizer to see the actual result before selecting the final implant.  You need to discuss carefully what your goals are with your plastic surgeon and allow him/her to do the best job possible to achieve a combination of size and shape to give you the best aesthetic outcome.Please enjoy the video link below regarding selection of implants which may be of help to you.  Best wishes for good result,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd

280cc or 300 cc? (photos)

Answers (6)

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