Is 600cc too big? Do I really need several surgeries to obtain a bigger size? (photos)

Question

Hello! I have saggy breasts and am a B cup. I am 5’10 and weigh 150 pounds I also have wider shoulders. After doing research I really want to get 600cc implants. But a friend warned me to not go over 350cc on your first time. I never heard that you need to “build up” to the size you want. I found a surgeon who said he can do a lift and implant through the aerola. Is this size too big? Do I really need several surgeries to obtain a bigger size?

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  When it comes to sizing there are a few things you have to take into consideration.  Nipple to crease distance, width of the breast, profile of implant are just a few.  Typically I would recommend and implant to be placed in the inframammary fold and not through the areola.  Scarring can be worse and nipple sensation loss tends to be a little bit higher.  I would ask your Surgeon what their thoughts are about size and how big they think they can go.  There are times when a patient wants a specific size and we can't obtain that the first time around.  Best of luck to you.

Nicholas Jones, MD, FACS · Answer

Thanks for your question!  Based on the photos, it appears that you have grade I ptosis and some mild breast asymmetry.  Augmentation mastopexy would be an ideal solution to increase breast volume and reposition the nipple aerolar complex on the breast mound.

in regards to volume, the size of breast implants are dictated by your desires and your underlying anatomy, most importantly, your breast width.  In addition, a breast lift and a breast augmentation or opposing procedures.  As a breast lift is done to tighten the skin envelope whereas an augmentation expands the envelope.  So, if a really large implant is used, the skin can be compromised and lead to wound healing issues such as: wound separation, nipple necrosis, skin necrosis.

Hope this helps!

Gary M. Horndeski, MD · Answer

Your breasts are very ptotic and widely separated.  The technique I recommend is a lift using The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained.  Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Camille Cash, MD · Answer

Selecting the correct implant for you will depend on what size you'd like to be after surgery.  Depending on your breast width and goals it is very possible to place a 600cc implant initially.  In addition to volume your surgeon will also help you decide on shape and profile which will influence your final look.  From the submitted photos it appears you will need more than a periareolar lift for a good result.  If you are unsure how to proceed you can visit with another board certified plastic surgeon in your area for a second opinion.

Daniel Barrett, MD · Answer

Dear sabrina2112,
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

Is 600cc too big? Do I really need several surgeries to obtain a bigger size? (photos)

Answers (8)

Answer: Implant size

Answer: Implant size

Answer: Implant size

Answer: Implant size

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Everything you need to know about Breast Augmentation

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Is 600cc too big? Do I really need several surgeries to obtain a bigger size? (photos)

Answers (8)

Answer: Implant size

Answer: Implant size

Answer: Implant size

Answer: Implant size

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Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.