Is 450cc saline unders too big for me? I'm 34A/32B, 5'6", 140 lbs. I want to be a full D/DD, proportioned to my body. (Photo)

Question

I'm getting a breast augmentation in 7 days and decided on 450cc saline implants under the muscle. I'm currently about a 34a/32b. I'm 5ft 6inchs 140 pounds. My ps said my ribs are flat which makes my breasts go off to the side a bit. I want to be about a nice full D/DD but want to stay proportioned to my body. My PS didn't help me decide on size much just had me try on these tear drop implants with a bra. The cc's look so different on everyone so that's why I'm so confused. Please help.

Ronald J. Edelson, MD · Answer

For your build and your goals, I think 450 cc's is perfect.  I also prefer saline implants, but they must be under the muscle.  Women with saline implants have far fewer problems and repeat operations than those with silicone gel.  They also provide more peace of mind, although I know many of my colleagues prefer silicone.  I also prefer smooth round high profile implants. They tend to feel nicer and have less rippling.  Textured teardrop implants feel very plastic like and tend to ripple more so they should be avoided. 450 Cc's will make you a D cup, probably not a DD.  Don't go any larger than that though.  Realself is full of unhappy women who regret having been made too large!

Ricardo Vega, MD · Answer

Hello,  in my opinion a regular D can be considered maximun new  cup size if armonic body proportions is your goal. Nevertheless you have time for sizzing wirh your ps. Consider a small D can be prob. a better choice. Best wishes. .

Gregory T. Lynam, MD · Answer

Lets be honest a D or DD is not proportional for your height and weight! Now that that is out of the way the size you have selected is fine. I would stay in the moderate plus profile so the implant is not too wide for your frame. I think this size is at the upper limit before you overload your soft tissue envelope and increase the risks of complications. Good Luck and please update us!

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question. In general, implant size does not 
correlate with bra cup size.  The cup size itself will vary from 
manufacturer to manufacturer as well as who is doing the actual 
measurements.  Thus, cup size is never a reliable indicator for your 
breast size.  I typically encourage my patients not to communicate her 
desires in cup size but more on the actual look and appearance.  Your 
options would certainly be breast augmentation with implants or fat 
grafting. Good communication between you and your surgeon of 
your expectations is warranted - choosing your surgeon wisely is the 
first step.  Discussion of your wishes and having an honest and open 
dialog of your procedure is mandatory (e.g, implant type, incision, 
placement, lift, etc).  I have found that photographs brought by the 
patient is helpful to get a visualization of the appearance you wish for
 in terms of size, shape, fullness, etc.  In addition, your surgeon's 
pre and postoperative photographs should demonstrate a realistic goal 
for you.  Once this has been accomplished, allow your surgeon to utilize
 his/her best medical judgment during the procedure to finesse the best 
possible result for you after preoperative biodimensional planning and 
fitting the right implant for your breast width. Hope me that this helps!  Best wishes for a wonderful result!

Ryan Neinstein, MD, FRCSC · Answer

Thanks for the question, 450cc for your small frame should give you the full look you desire, if you are concerned schedule another appointment with your doc!

Vincent N. Zubowicz, MD · Answer

As regards size I think 450 mL is suitable. Since the implant will make up the vast majority of the breast of volume I think silicone gel aesthetically would be a better choice.

Jarrod Little, MD · Answer

450cc saline implants may lead to a very unnatural, and disproportionate result for someone of your size.  A 450cc implant could be anywhere from approximately 11.5 to 14.5cm wide, depending on the projection of the implant.  This may be too wide for your frame and give a disproportionate result.  Additionally, an implant of this size may place you at a higher risk for long-term complications, such as capsular contracture, and need for futher procedures.  It is never a bad idea to obtain advice from another Plastic Surgeon. Good surgeons welcome second-opinions!

Robert Singer, MD · Answer

The best cosmetic
result in any particular breast augmentation patient depends on a variety of
factors, including: your individual anatomy, realistic expectations, a thorough
discussion with the plastic surgeon about the options, and an understanding of
the pros and cons of any particular implant choice. Proper sizing is not just
about the number of cc’s. The thickness of your tissue, breast dimensions which
include the width, height, and projection, as well as chest wall width all need
to be considered when choosing an implant. Trying on implant “sizers” of
various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit
at a preoperative visit will help you and your surgeon choose the optimal
implant.

There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 32 D/DD and a 38 D/DD are significantly different. Cup size varies from
manufacturer to manufacturer and even within styles from any particular
manufacturer.

Keep in mind that following the advice from a surgeon on this or any other
website who proposes to tell you exactly what to do without examining you,
physically feeling the tissue, assessing your desired outcome, taking a full
medical history, and discussing the pros and cons of each operative procedure
would not be in your best interest. I would suggest that you discuss your concerns directly with your plastic surgeon  who should be certified by the American Board of Plastic Surgery and ideally a member of the
American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are
comfortable with. 
Robert Singer, MD FACS

La Jolla, California

Eric Desman, MD · Answer

Your questions are great and appropriate. Unfortunately, an online 
forum is not going to be much help in answering your questions.Sizing of breast 
implants is a very individualized 
process. Essentially, you need to custom fit the implants to your body. 
In order to properly size implants, you need measurements of several key
 
items. Regardless of what manufacturer of implant your surgeon uses, 
they all have what is called dimensional fitting systems. These systems 
basically take some measurements of your breast width, height, and 
tissue stretch to determine the optimal volume for your particular 
tissues. i.e. What can your tissues handle? Thus your comment "I want to be a full D/DD, proportioned to my body" is not consistent. Measurements may determine that proportioned to your body and fitting your frame may only get you into a C cup bra. I can't tell this online. Also, remember, cup size is not standardized and there is no guarantee of cup size with your surgery. If you truly want implants as large as they can be while still being proportioned to your body, then a dimensional measuring system will work great for you.Measuring your tissues to determine the ideal implant size for your body, i.e. properly proportioned, is the "science" of 
determining the optimal size implant for your tissues. The artistry with
 your surgeon comes in taking the ideal size and working with some 
judgement to get you as close as possible to your desired outcome.  So 
someone 5'6" 140 lbs with
 3 children vs. someone with no children may have different optimal 
volumes due to the differential stretch in their tissues.  You can 
Google
 "High Five Augmentation" to get a quick idea of the process.Good luck.

C. Bob Basu, MD, MPH, FACS · Answer

There are several factors that plastic surgeons consider when recommending implant sizes. I consider two factors when selecting implants for my patients:1. Dimensional planning2. Gel Implant Sizing systemDimensional 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. Your surgeon can review this with you during the consultation.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. BasuHouston, TX

Is 450cc saline unders too big for me? I'm 34A/32B, 5'6", 140 lbs. I want to be a full D/DD, proportioned to my body. (Photo)

Answers (14)

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