Natural looking if I go 450cc? For Petites 5'2", 110 lbs (Photo)

Question

I had 371cc BA and I am 30DDD now. I'm thinking to do reversion since I have capsular contracture on left side. If I go though the surgery again, I want to go little bigger. I like my right size, looking natural. Does 450-500cc look still natural ? Or too big to look natural ?

Shlomo Widder, MD · Answer

Dear Yolo,  Thanks for submitting your picture, however front picture without cloths would have been very helpful. The best that I can do from observing your picture, is to guess that  your right breast is full D cup size presently.     Your left breast has severe capsule contracture and based on my 29 years of practice, I would strongly recommend complete capsulectomy and implants replacement in order to reduce dramatically the chance of capsule contracture recurrence (read about Biofilm).  A 32 full D cup size is quite big for a petite woman, however it can look natural if they are soft and perky  with nice cleavage and slope. So increasing your implants size from 371 cc to 500 cc, will increase your breasts by one size to 32 full DD . Obviously, no one will believe that a petite person has such size naturally, but it can be very attractive when done well.    When you are young, such large size is not a problem, but when you will get older, you might consider size reduction with possible skin tightening.   Always, consult with experienced board certified plastic surgeons who do lots of redo breasts augmentation in accredited surgery center for your safety. Most importantly, check the before and after pictures to make sure that they are numerous, consistent and attractive.                  Best of luck,                                     Dr Widder

Gerald Minniti, MD, FACS · Answer

Hello,It would be impossible to prognosticate how you'll feel about your appearance after revision surgery and implant exchange to larger implants. A change to 450 cc is an increase of 22%, and to 500 cc is 35%; which would be roughly equivalent to a small and moderate change in apparent size. Whether either of these plans are medically recommended would require a physical examination.  If you have capsular contracture, you should make sure your surgeon performs either a total en bloc capsulectomy through an inframammary incision or a subtotal capsulectomy with the use of an ADM, also through an inframammary incision. Revision surgery is complex, and you should minimize your risk of recurrent capsular contracture. Best of luck!

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

Milind K. Ambe, MD · Answer

This is a difficult one to answer because as with everything beauty is in the eye of the beholder.  Your idea of fake might be different then someone elses.  I personally feel that 500cc will be too big on your petite frame but I would first want to see pictures of the look you wish to achieve before deciding if that's the right size for your desired look.  In addition this would require an in person exam to take a look at your current breast measurements to best evaluate.

Malcolm A. Lesavoy, MD, FACS · Answer

From your description and your height and weight, I personally feel that 450 cc implants may be too big for your breasts, and will give you a "fake" breast appearance.

Michael C. Edwards, MD, FACS · Answer

The best way for a board-certified plastic surgeon to answer your question and guide you in your revision decision will be to meet you and examine you. You are very petite and first need improvement of your left side capsular contracture. The implant(s) used to replace your current implants need to be chosen carefully to match the dimensions of your breasts. Going up to the 450cc range does not seem unreasonable but an exam will be able to tell.I hope this helps.Dr.. Edwards

Steven Wallach, MD · Answer

The larger the implant the more likely it will look less natural.  Best to be seen in person to determine what might be appropriate for you.

Andrew T. Cohen, MD, FACS · Answer

Hard to say without a good exam by a BCPS.  I would say that going up to a 445 Allergan Inspira implant would most likely make you a D or DD cup as you are petite. The moderate profile would be best as it will look more like your right side. You want to go to a surgeon who does lots of revisions and is a breast specialist and BCPS. You will do very well I am sure.Good luck,Andrew Cohen MD

Justin West, MD · Answer

Hi and thank you for the question. An extra 79cc's shouldn't dramatically change the appearance of your breasts. One thing to consider is to find a practice like ours that uses the Vectra 3-D imaging system. We can use this to show you what you would look like  with different sizes and styles of implants. This could help you determine if you want to stay the same size or go with larger implants during your next surgery. Hope this helps.Dr. West

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. Online consultants will not be able to provide you with specific enough advice to be truly helpful.

Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery 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. I have found that the use of words such as “natural” or "up a cup size” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.

3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.
I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.

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