Should I get 430 cc or 535 cc teardrop implants?

Question

I’m 5ft 8 , 176 pounds ! I’m going to do a lift aswell .. and I’m sooo confused which size I’m having .. any opinions please ??

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well..Based on your question, ideally, consult in person with a certified plastic surgeon so he can see how many cc's are necessary to get the result you want.

Joe Gryskiewicz, MD, FACS · Answer

Hi Dd,It is a funny thing, but all the studies show no difference between the two shapes teardrop or round in postop studies.  I am speaking in China and doing live surgery and all the Chinese surgeons here at the meeting also agree with us in the US that it is no more than marketing hype.  Now for your size,  I feel you are on the right track. Especially since you are tall.  
Here are a few tips for you because this is perhaps
the hardest decision for a patient to make, as well as the surgeon.  Also see the video attached to my answer.  We spend up to two hours for our BA consults
to be sure there is careful communication. We do a full exam in front of a
full-length mirror taking six exact measurements.    We
put your photos on a large computer screen for imaging, and go over your
“ideal-size” photos. We then save this information to your password protected
“web account.” 
     First and
foremost the implant should fit the dimensions of your breast and tissue cover.
 Balancing the implant to your
over-all body shape and tissue cover is essential.    The main thing is to
have the diameter of the implant fit the diameter of your breast "foot-print".
 Higher profile implants tend to have a smaller diameter.  Higher is really a marketing term, but often
translates into the same volume implant with a narrower base.  Saline implants actually tend to decrease in
diameter as they are inflated!  The average size chosen over our last 7,000 breast implants was
“350cc”.  BUT, 90% of our patients tell us they wish they were
bigger a year after BA.  (We will see you
every year for routine checks at no charge.) It’s like your mind incorporates
the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
 You can try on implants in the office by
placing them into a special bra.  The implant is also flattened somewhat when under
the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket.  Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues.  Multiple measurements need to
be taken to fit an implant to your exact anatomy.  Have your surgeon's
office show you the charts of the implant dimensions for the various profiles
of silicone and saline from the manufacturer.  Then you and your surgeon
can piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan.  Keep in mind
larger implants tend to have more problems over the years.  Since silicone implants wrinkle less than
saline implants, they might be your best bet.
     You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra.  Wear this around the house for a while, and
see what you think.  Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
 Multiple measurements of your chest wall
are taken (seven in total).  Implant size
selection has been an issue of much discussion. 
    
Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.  Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape.  A photo album of patient
pictures is maintained to assist them.  These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery.  In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover.  Finally,
your verbal requests are factored into the analysis. 
     We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals.  It is a surgical procedure that
uses special instruments and techniques to minimize tissue damage and avoid
touching the ribs. It causes far less trauma to surrounding tissue than
traditional approaches, and it dramatically reduces pain and recovery time. In
published studies of BA patients, 95-percent of women interviewed after the
procedure returned to normal daily activities within 24-hours. Quick-recovery
BA is not a “gimmick.”  These specialized
techniques, which actually speed recovery and get you back to your daily
routine, kids and work, are published in our plastic surgery journals.  Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.  
     Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons).  Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year.  Be sure the PS has been in practice for a
while, about 20-years might be a good gauge. 
Does the PS offer all three incisions? 
Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach." 
Ask to see their before and after photos if you didn’t see any on their
website.  If they are experienced, they should have several 100 breast
implant patients for you to view.  I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you.  You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center.  Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.      
All the best, “Dr. Joe”

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I do this with my patients, we then look at pictures of women with similar measurements with different size breast implants. My patients tell me that this process is very helpful in determining what size breast implant is right for them.
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

Tom J. Pousti, MD · Answer

Thank you for the question.   
 Generally speaking, patients undergoing the breast augmentation/lifting combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery. 
Also, patients undergoing the combination breast augmentation/lifting surgery should understand that there are limits as to how large of an outcome can be achieved, given that breast lifting surgery does involve breast skin removal. On the one hand, breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope. These 2 forces are counteracting each other. 
Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications. 
In my practice, "tailor tacking" is an important part of the mastopexy and mastopexy/augmentation procedure. It involves TEMPORARY  closure of the skin (for example with temporary skin staples)  to double check the amount of skin that is to be excised during the procedure. This maneuver is done to ensure that enough skin, but not too much, is removed. On the one hand, it is important that enough skin be removed to achieve the aesthetic breast lifting results the patient is looking for; on the other hand, is important not to move too much skin creating tension upon closure and potential wide scars.Anatomical breast implants were designed to better simulate the natural breast  shape;  the problem with these implants is that if they shift or rotate,  the entire breast will change shape as well.  This change in breast shape may require further surgery to correct. Round implants, on the other the hand, can shift or rotate without changing the shape of the breasts.
 
I personally prefer the use of smooth  and round implants for most patients.
 Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting 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. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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 look” or "C or D cup" 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. The use of computer imaging may be very helpful during this communication phase.
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. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.
Best wishes.

Brooke R. Seckel, MD, FACS (retired) · Answer

Congratulations on your decision to have a breast implant surgery.  Your choice of Seib is an extremely important decision which should be made in consultation with your surgeon and a personal examination.  The use of breast implant sizers can be very helpful.When I do a breast lift in addition to implants I prefer to use smaller implants in the 350-400 cc range because with larger implants over 500 my concern is that the large implant could interfere with blood supply to the nipple areola.  This is my personal choice and your plastic surgeon is the best person to advise you on this.

Should I get 430 cc or 535 cc teardrop implants?

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