Is 650 cc too big? (Photo)

Question

I’m 6’2 and 140 lbs with a narrow chest. I had a consultation and the doctor recommended I go between 650-700cc high profile. Is that going to be too big?

Daniel Reichner, MD, FACS · Answer

Excellent question! Choosing the right implant size is a critical decision when opting for breast augmentation. I always advise my patients not to solely rely on their plastic surgeon to determine the ideal size. Breast size and body proportions can vary significantly among individuals, depending on their unique body image. Several important factors come into play when deciding on the size of breast implants, such as height and weight, chest size, breast asymmetry, and the quality/thickness of both the skin and breast tissue. Considering these factors will help ensure the best possible outcome for each individual patient.

Daniel Barrett, MD · Answer

Dear tgf12,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Carlos Marciales, MD · Answer

It depends on the result you want to have, but an implant of more than 600 s large, also think about the weight you are going to add to your back.

Brian K. Reedy, MD · Answer

Thanks for your question! When you are a bit taller, you can certainly accommodate more implant than someone who is much shorter without looking top heavy. Your shoulders, hips, waist, etc also play a role. I would suggest following the advice of your surgeon if you like what you are seeing. Good luck!

Ted Eisenberg, DO, FACOS, FAACS · Answer

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, and they choose what looks right for them. 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

Eric Pugash, MD · Answer

The First Rule of breast implants is this: the bigger the implant, the bigger the trouble. Large implants damage the breast tissue through excessive weight and stretching; they may make it difficult to fit clothing and to find appropriate lingerie; and I believe they are associated with higher rates of capsular contracture since a large implant cannot really remain under the muscle, where the risk of contracture is reduced. I have found that very large implants often lead to very large, very hard breasts which are difficult, complicated, and expensive to fix. I try almost never to go over 500cc - this can be a challenge in patients with a larger or taller build, since the implant appears smaller, but I think the priority should always be to try to minimize potential problems and to keep the patient (and surgeon) out of trouble. All the best.

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. As you undoubtedly know, a precise treatment plan or specific implant recommendation can only be determined with a careful examination and detailed discussion with your plastic surgeon. Volume (300 versus 400), is far less significant than implant width and projection. Implant width is similar to shoe size. The implant literally needs to fit into your breast and chest. The 650cc implant your plastic surgeon suggested may well “fit” your breast, but the volume and projection are what will determine the “look” you want, similar to the style or type of shoe you would select. “Big” versus “small” are subjective and the number of cc’s is not particularly relevant. Proportion is key. It is true that for a given volume a high profile implant will have a narrower diameter, and it is also true that a person such as you with a relatively tall frame and broader chest will require a wider diameter implant than a patient with a narrower chest or petite frame.  Other considerations such as saline versus silicone are also important, as are "round" versus "anatomical" or "form stable" or "shaped", smooth surface versus textured, and softer versus firmer with the different levels of gel cohesivity.

The term “natural” can mean different things to different people and the profile of the implant does not necessarily determine that. You can certainly achieve a “natural” appearing result with a high profile implant if properly selected, but as a rule, the larger the implant and the higher the profile, and certainly if the implant is positioned too high, the greater the chances you will look “augmented” because of exaggerated upper pole fullness or convexity.

In my practice, besides a thorough interview process and physical examination with careful measurements, we use on lay sizers within an unpadded bra to help you understand what you are likely to look like in a bra, bathing suit, or T-shirt with a given size implant. In addition, and this is critical, we ask all of our patients to provide us with photos of their desired final look, with images of women’s breasts that most closely resemble the look they are trying to achieve. This serves as a visual guide that thankfully rarely leads us astray. The most common reason for patient disappointment after breast augmentation is size-too big or not big enough. This algorithm which we have been employing for over thirty years has proven to be very successful.

Because all of these factors can leave you quite confused, it is crucial that you select an experienced board certified plastic surgeon whose aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion if necessary to be sure and feel confident about moving forward with scheduling surgery. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

Camille Cash, MD · Answer

Those like yourself who are taller can sometimes accommodate larger implants better than others.  I encourage you to return to your surgeon to further discuss your selection.  Often times surgeons have sample implants you can "try on" to help you get a feel for how you may look after surgery.  I've included a video on implant selection that I hope you find helpful.

Connie Hiers, MD, FACS · Answer

Those implants are very large and heavy for someone with not a lot of tissue, and you will feel a lot of the implant in your breast. I would suggest going back to your surgeon and ask to try on those sizes and even some smaller sizes so you can feel the weight and see how it will look with clothing on, which is how you will be for most of the day.

Joshua Jacobson, MD - Account Suspended · Answer

Hi. We usually estimate the implant size by the width of your breast. If you measure that and post it, we can answer your question better.

Is 650 cc too big? (Photo)

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