I went for a consult today- We decided on 440cc saline implants under the muscle...(Photos)

You mentioned you wanted "fuller, larger, but not over the top and not past a C cup".  I believe 440 cc implants will put you well into the D cup range.  At 5 feet 4 inches, 115 lbs, I believe you will find a implant volume between 275cc up to 375cc will allow you to achieve what you want.  Important considerations are: 1) how wide your breasts are and the distance from your nipple to the fold under your breasts under full stretch.  If you choose an implant whose measurements exceed those measurements of your breast, the boundrys of your breast, such as your natural fold under your breasts, must be divided to fit this larger implant and this will result in an unnatural appearance and potential future problems.  I use 2 methods to help patients determine what would fit them best and give a proportional increase in breast size.  A 3-D system called Crisalix allows scanning of your breast dimensions and then allows virtual 3-D visualization of what your breasts would look like with different implant sizes inside.  Several simulations can be compared side by side to see the subtle changes from one implant size to the next.  I also have multiple implants patients can try on under their clothes and look in the mirror to give them an idea of what can be achieved.  For the most natural appearance I always place implants under the muscle and the vast majority of my patients use silicone implants as they have the most natural feel and appearance, especially in slimmer patients.  Seeking other opinions may be helpful. Always see a board certified plastic surgeon.  

I appreciate your question.



The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  



Silicone will give you a fullness at the top (upper pole fullness).



Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.



Anatomic gummy bear implants might be a good choice to give you volume.



These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.



During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.



The best way to assess and give true advice would be an in-person exam.



Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.



Best of luck!



Dr. Schwartz



Board Certified Plastic Surgeon



#RealSelf100Surgeon



#RealSelfCORESurgeon

Thanks for the question and photos.  To determine if you "like" this size, we use a couple of different techniques.  A new technology we have is made by Crisalix and allows us to "scan" a patient and then show you what you would look like with different implant sizes.  Then you can put on virtual reality glasses and truly see your new breasts in 3D.  Although this is very new technology patients have found it to be very helpful in determining a size.  And then we also use the old fashioned method of trying on implants in a bra.  In my humble opinion 440 cc will definitely take you past the C cup range and well into the D cup range.  My advice is to always place the implants below the muscle and truthfully more people choose silicone gel implants due to their more natural feel and look.Probably worthwhile circling back to your plastic surgeon or visiting another since I fear that you might find 440 cc ultimately to be "over the top!"Best of luck!