34 B debating 286 cc or 304 cc silicon implants. Want a natural look. 5'8" and 145lbs with broad shoulders. (photos)

A tear drop shape breast can be achieved  augmentation can be achieved with a saline filled breast implant, a silicone filled shaped implant and sometimes with a silicone filled small or moderate profile round implant.In my practice, when patients ask for a "natural tear drop shape" breast augmentation, I always ask the patient" do you want cleave or not? do you want upper pole fullness or not?. 99% of the time the patients respond yes to those questions, then I explain to them that a "tear drop shape breast augmentation" won't deliver those features. Right after they understand they do want a round implant.When choosing the implant type, breast augmentation patients should discuss what they seek to achieve with breast augmentation to avoid post-surgical dissatisfaction. 

As much as it's important to know what size bra you currently wear, the strap size is important to know as well. It affects the diameter of the cup and subsequently the diameter of the #breast implant that you choose. In my practice, about 15-20% of the patients are good candidates for silicone #shapedimplants.This may provide some insight. If a woman wears a size 36 AB bra and would like to be a C cup, which is the average size that women wear and the average size bra that is sold, she needs a volume of approximately 350 to 390 cc to make that change. This becomes less if she's wearing a 34 bra, because it has a smaller strap size and the cups have a smaller diameter. A smaller diameter implant would then be a volume of approximately 300 to 350 cc. In the same way if she was more petite, maybe a double zero or size one and wore a 32 AB bra, then to become a 32C cup she would only require about 250 to 300 cc. The profile is determined by the amount of projection versus roundness that the you desire, as well as the size of the implant and size of your chest. Other factors which contribute to the outcome are #size, #shape, and #profile. The #profile is determined by the amount of #projection versus roundness that the you desire, as well as the #size of the implant and size of your chest. Also, the placement or incision location will also have an effect on profile. Your Plastic Surgeon will measure you to determine the best shape, size and placement of the #implants to be used. Lastly, another important element to a satisfying result of your #augmentation is realistic #expectations.

For a natural look, we choose implant volumes based on a patient's chest and breast dimensions. These measurements should be your guide if you desire a natural appearing breast augmentation result.

Hello,Here are a few points for you to think about. 1. Implant size has more of an impact then anything else on your breasts appearance.  Smaller always looks more 'natural'. 2. There is a 97% chance that your surgeon only recommends round implants.  Most American surgeons are fearful of shaped implants due to their unique potential for rotation, something that happens far less than round implants tendency to drop out or to the sides. Although most opposed will argue that 'there is no difference in appearance', it's less about initial appearance, and more about durability of result over the years.  That's because shaped implants do not rely on your soft tissue envelope to support or give them shape; instead, they shape the soft tissue envelope.3. If you wanted shaped implants, you'd be a great candidate.4. You and your surgeon should know which implant you're getting before surgery.  This is based on your aesthetic goals and your biodimensional analysis.  There is no reason for the use of sizers in the operating room, or waking up wondering what implant was use.5. Regardless of which implant type or size you pick, you  look like you're going to have a great result!Best of lukc!

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

Director-Beverly
Hills Breast and Body Institute

#RealSelf100Surgeon

The two sizing that your are referring to are very close.  The difference is essentially a shot glass of volume.  I would listen to your plastic surgeon and let him or her decide which implant would give you the result you are looking for.As far as round vs anatomic, given your breast volume, I personally don't feel there is any advantage to placing anatomic implants for you.  Given the amount of breast volume that you have, you can achieve a very natural result with round implants and avoid the firmness and possibility of rotation that anatomic implants present.Good luck.

If you trust your surgeon, best to go with his or her suggestions. I personally prefer round implants because they are cheaper and even most surgeons can't tell the difference between the two types of implants once placed in the breast pocket for a breast augmentation patient. However, if the shaped implant rotates, you can usually tell! Also, there is not much difference between a 286 and 304cc implant but if you are more conservative, best to go with the smaller size. Hope this helps!

Hi Collette,I think either implant size will give you a natural look.  The difference between the two is so minimal you should pick based on your goal.  If you are worried that you will go through the BAM and be to "small" - pick the larger implant.  If you are worried that "everyone will know I have implants because they will be big" - pick the smaller implant.The reality is that you will be in the same bra post op with either implant and either will look amazing when done be an experienced PS.For greater upper pole and cleavage my patients select Allergan Inspira Round SRX or SSX implants in the submuscular plane.you will soon appreciate that BAM is a truly transforming procedure for women.  All the best.Scott Barr, MD. FRCSC, Plastic Surgeon

Because of your body size and the size of your breast now, you could easily have the larger 304 cc implants and have a natural look, however, it really is up to your surgeon at the time of surgery to see what fits best, taking into account your desires.

Thank you for the question and good quality photographs. 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.   In my practice, I would also recommend the use of smooth round silicone gel breast implants placed in the sub muscular (dual plane) position.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” 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. 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.