5’4 and 115 pounds. What size implant should I choose? 220cc or 250cc? (Photos)

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing. Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and breast surgeon create your custom surgical plan.
Based upon your photos, your choices sound reasonable. I would not struggle over tiny implant variations. This unlikely to make a significant difference in outcome. It is also important to remember that the implant width has a negligible impact on spacing. The implant needs to site behind the native breast in order to be appropriately aligned.
As always, discuss your concerns with a board certified plastic surgeon.

Dear Phenomenal660308,

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

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Thank you for your question. The difference of 30 grams between the implants you are considering are somewhat negligible. The 0.25 cm difference in width may also not be of considerable consequence. The results after breast augmentation at this point will depend on your tissue quality and your surgeon's ability. Between the 2 implants choices, the differences will be unnoticeable. Good luck on your journey!

This decision is best made in person alongside your plastic surgeon. She/He has had the opportunity to examine you and discuss your surgical goals. Many surgeons have sample implants available that you can "try on" to give you an idea of how you'll look after surgery. I like to use breast implant sizers during surgery to help my patients achieve the look they are wanting. In general, both implants you are considering should give you a nice result.

Each plastic surgeon will have their own way of guiding patients through the implant selection process.
Some plastic surgeons to do a better job of this than others.
It is your plastic surgeons responsibility to help you with this.
Some plastic surgeons will have the patient make the final decision regarding what implants do use.
Other plastic surgeons will make the decision based on input from the patient.
My personal approach is to work with before and after pictures of previous patients who had similar body characteristics.
Once I have a good understanding of what the patient is hoping to achieve I bring those representative pictures with me to use as a reference during surgery.
During the operation I use temporary implant sizes to determine what size and shape implant will give the desired outcome.
I typically have a full selection of implants available to me during surgery.
I found this to be the most accurate way of determining what implants to use.
It does require that the surgeon have an implant inventory or be willing to send back all the unused implants.
I think it would be inappropriate for us to tell you what implants to use.
Good luck,
Mats Hagstrom MD