Should I go with 365cc under muscle or 400cc?

Question

So I had my consultation with my surgeon on Saturday for my BA and decided to go 365cc under muscle but not I’m thinking I may want to got 400cc instead I have my pre op coming p this Saturday 24th March & was wondering if anyone knows if I can change my mind?? Thanks in advance :)

Donovan Rosas, MD · Answer

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. This will ensure that you avoid the dreaded "fake" look.
With regards to your specific question, I would not stress over such a small volume differential. 35 cc amounts to 7 teaspoons or less than the volume of a shot glass. It is unlikely to make more than a subtle difference which most would be unable to discern post op.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Rodney A. Green, MD · Answer

The implants are generally shipped overnight by the manufacturer. Your surgeon should be able to change the implant size if there is enough time to do this. The question is also if you should change the size at all. There is not that much difference between 365 and 400 mL. I would recommend the smallest implant that satisfies you need.I always have my patients try on implants externally in a bra and with a T-shirt to decide what size they would like. This gives a very good idea of the size of the breast after surgery. The actual implant that is chosen will also depend on the size of your chest.Good luck.

Daniel Barrett, MD · Answer

Dear Kirsty Marie,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

Stephen T. Greenberg, MD, FACS · Answer

Hi and thanks for your question. Once the implants are placed under the muscle, can they tend to appear a little smaller. If you desire a larger breast size, you may want to consider using the 400cc implants. The difference between the 360cc and 400cc implants is only 40cc which isn't a drastic difference. I recommend having an additional sizing meeting prior to your surgery to go over what implant is suitable for you. Hope this helps and best of luck.

Miguel Delgado, MD · Answer

This is a difficult decision for many women. I have my patients do the "rice test" to visualize how they will look with different size implants. Of interest, there are more women who wish that they went larger rather than smaller. However, 35cc is less than 2.5 tablespoons. Good luck.

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Should I go with 365cc under muscle or 400cc?

Answers (10)

Answer: Implant Size

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