34A/B and 450 cc HP implants - what size will I likely be?

Question

I recently saw my surgeon and my BA is due on Valentines Day (best gift to myself ) so :) my current size 34 A/B. im 5'6 and weigh about 10 st . He offered me anything from 300cc to 450cc ... I chose the largest one (boob greed) he said there is no way he'd give me more than that (why is that??) What size will i likely be afterwards ? Thank you !!

William Andrade, MD · Answer

Hello, it is not possible to second guess your surgeon's advice without a proper examination, but possibly they feel that implants larger than 450cc are too big or they simply won't fit within the breast pocket.  There are limitations to how much the tissue will stretch.

Shlomo Widder, MD · Answer

Dear Monica,   Front and side view pictures would have been very helpful. If  indeed you are 34 small B cup size,  450 cc implants will bring you to 34 full D cup size.   In my practice, I measure myself the chest and breasts circumference in inches, to obtain the true bra size. I have noticed in my over 29 years of practice, that women tend to over estimate their breasts size, because Victoria secrets make the bra size smaller, so women feel better about their breasts size. If in reality, you are true 34 A cup size or small A cup size, than 450 cc will bring you only to 34 full C cup (very nice and natural size - most popular in my practice).   I can't answer, why your surgeon does not feel comfortable with bigger implants for you. It is not unusual for me to use implants that are bigger than 450 cc on patients with chest circumference of 34 inches.   If you are not satisfied with the recommended implants' size, consult with other experience board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical , large size and natural looking.                   Best of luck,                                       Dr Widder

Janet Woodyard, MD · Answer

These are all questions to discuss with your surgeon who has examined you. You should feel completely free to ask as many questions as you have before proceeding with surgery so you are comfortable with your decisions. Trust your surgeon. If you don't, then you should seek a new one. Best of luck.

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.   Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Lawrence Scott Ennis, MD, FACS · Answer

The best way to pick implant size is based on your breast and chest width and not the volume. As the implants get bigger, they get wider. When the width of the implant fits the width of your chest, it will look nice and fit your frame. If the implants are too small, you will have a gap between them and they may look too far apart. If they are too wide, they will make you look top heavy as they may be too wide and stick well out past the sides of your chest. There are ways to get a bigger or smaller look.This can be done by picking a different implant profile. The higher the profile, the narrower the base width of the implant. If someone has a very narrow chest and wants to be big, they should consider a higher profile implant. If someone has a broad chest and they do not want to be too big but want to avoid the gap and still have cleavage without projection, they should consider a lower profile implant such as a moderate. There are options in between these such as the moderate plus. I prefer the underarm approach so there is no scar on your breast. The new silicone is the only way to go as far a rippling as the new silicone ripples much less than saline, especially in the larger implants. I personally prefer the smooth round implants under the muscle placed through the under arm to give you the most natural look and feel. This also leaves you no scar on your breast. Dr Scott Ennis

Reza Momeni, MD, FACS · Answer

Choosing breast implants is a detailed process that requires an in-person examination and trying out sizers to see which you like better.  it cannot be done on the internet if you expect actually good results.  Be sure to discuss with your board certified plastic surgeon exactly what your goals are, and how reliably they can be expected to be achieved.

Ralph R. Garramone, MD · Answer

I don't discuss postoperative bra size with patients because many women wear the incorrect sized bra to start with before surgery and bra manufacturers are not uniform with regard to size so you may a different size depending on where you buy your bra.  Implant size on the other hand is a discussion I have will all patients.  There is a limit to the size implant that can be placed.  I would not be surprised if your plastic surgeon finds that he is difficulty fitting that 450cc implant in someone who is a 34A.  The skin and breast tissue and muscle all have to stretch to accommodate the implant and there is a limit as to what size can be placed at the time of surgery.  Best of luck.

Tom J. Pousti, MD · Answer

Thank you for the good question and congratulations on your decision to proceed with breast augmentation surgery.
Generally speaking, every patient undergoing breast augmentation surgery should understand that their anatomic starting point will limit the outcome of breast augmentation surgery.    In other words, a patient's starting anatomy will limit how large of a breast implant can be utilized safely. The use of a larger breast implant (than what is safely "allowed" by the patient's anatomy) can be problematic;  potential problems include breast implant displacement/malpostion issues ( such as bottoming out, lateral displacement, symmastia...)  and/or significant breast implant rippling/palpability.

There is no accurate/reliable/predictable correlation between size/profile breast implant utilized and cup size achieved. For example, I do not think that the generalizations of "200 cc equates to 1 cup" hold any validity or are helpful in any specific or practical way.  In my practice, I ask patients not to communicate their goals, or evaluate the outcome of the procedure performed, based on cup size references.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation 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. 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. For example, 
I have found that the use of words such as “natural” 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 him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

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, after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

34A/B and 450 cc HP implants - what size will I likely be?

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