Am I going too big? 34A to 450cc.

Question

I'm currently a 34A and at my consultation my surgeon recommended 400-450cc. I had my pre op visit today and they told me if I go with 400cc I would have a gap in between and 450cc would help that gap situation. I went a long with the 450cc my only concern is that I am going too big. I'm 5'1" and weigh about 105lbs I don't want to look ridiculous

Jaime S. Schwartz, MD, FACS · Answer

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

Gerald Minniti, MD, FACS · Answer

Hello,Implant size does not control or affect the gap, the surgical pocket and your anatomy do however. No mention was made about anatomic measurements to objectively determine an appropriate implant size. I presume that was not done. 450 is a big implant on someone 5'1''. Please go visit a few ABPS certified and ASAPS member surgeons.Best of luck!

Curtis Wong, MD · Answer

and if you say you don't want ridiculous, you should size with a friend who can give you some objective observations as you size implants.  A 450 cc implant would be near a 400-420 cc sizer in your unlined bra cup so try them on as there are implants of various styles and one should be able to fit on you assuming you like that look.  Understand that if you do go excessive for your frame, you risk more complications and additional surgery in the future to repair any adverse impacts of the large implants.

Andrew T. Cohen, MD, FACS · Answer

Have to see your picstures to know for sure.  I perform many augs each year ( hundreds).  I have been using the smooth round full profile Allergan implants for some time now and I feel that has been giving us the best results.   Best to have a formal exam.  Go to a board certified plastic surgeon

Tom J. Pousti, MD · Answer

Thank you for the question.

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, 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 "too big" 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.

Sara Yegiyants, MD, FACS · Answer

You have a legitimate concern in that 450 ml implant may be too big for someone with your dimensions.  You would benefit from pre operative imaging to get you a better idea of what that volume augmentation may look like. Best, Dr. Yegiyants

Ronald V. DeMars, MD (Retired) · Answer

It really depends on your goal look, but I find the majority of my patients in that ht/wt range go with 275-325cc and gt a pretty full look.

Jon A. Perlman, MD (retired) · Answer

A face to face examination is necessary however being 5' 1" tall and weighing 105 lbs I would be concerned that this is being fairly aggressive. You don't state your actual size goal in cup size and I don't know if you've had pregnancies or weight gain/loss, but I personally would in general be thinking of a smaller implant. Measurements are fine but implant position (subpectoral) and ultimate size and contour are my priorities to create a natural look and balance with proportioning.If you have doubts seek a second opinion. Watch the video above for my discussion of how I choose breast implant size at the time of the surgery for the optimal aesthetic outcome in my experience. Regards,

Jon A Perlman MD FACS

Certified, American Board of Plastic Surgery

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016

Beverly Hills, Ca

Jon A Perlman MD FACS

Certified, American Board of Plastic Surgery

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016

Beverly Hills, Ca

Am I going too big? 34A to 450cc.

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