Why won't my PS put a larger implant in? Is 350cc too small?

My PS says that a 325cc or a 350cc implant will be the right size. I am 5'3 117 pounds and my bwd is 11.7. He said I would not be able to fit a large implant in my chest due to my diameter and small chest wall and that the 350cc is proportionate to my body but they will look smaller under the muscle . The 350ccs already match my bwd. I'm looking to be a small d. I know that with specific pts this implant is big enough and with others a 400cc is required. Do I listen to my PS and get a 350cc?

Doctor Answers 16

Implant sizing

Thank you for your questio Please know that it is a common misconception that implant size correlates with the bra cup size. Many patients are often confused regarding that because of reading reviews or hearing about what their friends got.  First, bra sizes clearly vary among manufacturers, and they can label the cup size by any designation they choose. So when you say you want a small d-cup, it is not much helpful to us surgeons. But if you have specific measurements, and a specific bra, then the discussion can move forward. Second, there is a confusion over sister sizers which complicates things. For example, a patient wearing a 34C may also fit into a 36B bra. With so many problems, it is no surprise that many patients are dissatisfied with their outcomes. Thus, establishment of an accurate band-size is important, as is recognition that cup sizes are a range and ever changing.  Even though you may give importance to cup size designation, what should matter most is that the implant looks good aesthetically and that the chosen bra fits and feels comfortable. This is exactly why patients must have a consultation. I am assuming you have gone to a board-certified plastic surgeon, and I believe they have assisted you in choosing an implant that is more tailored to your breast characteristics. They must have done this because if you want natural looking breasts, the implant has to fit YOUR body dimensions. The more you deviate from the proper fit, the more fake your breasts will look. For this reason, please follow your surgeon’s recommendation regarding implant selection as long as you trust them. Surgeons use what is called tissue-based planning. The planning takes into account the effects of implants on tissues over time, risks of excessive stretch, excessive thinning, visible or palpable implant edges, visible traction rippling, ptosis (Sagging), and breast tissue wasting. To determine the implant size, breast measurements must be made: 1) Base Width of the existing breast tissue, 2) skin stretch, and 3) Nipple-to-Inframammary Fold distance. The combination of these measurements will help determine tissue coverage and the required implant volume to optimally fill the breasts. For example, if your breast base is very wide, we will require a higher implant volume to avoid the “rock in a sock” appearance. If you choose a large implant that exceeds your breast boundaries, or which overly stretches your breasts, or is too round, then it will make your breasts look unnatural. In fact, there is higher likelihood of bottoming out (i.e., an empty upper pole, nipple sitting too high on the breast), double bubble deformity, implant malposition, implant visibility, breast sagging, and breast tissue wasting. So going big is good, but going beyond limits will get you in big trouble…pun intended.  Now, if we consider a single bra manufacturer of a single style, then we can say that if you are currently at a B-cup (please note that this is my assumption), the chosen size of 350 cc may get you to a “small” D-cup. I say this because a study by Dr. Bengtson and Dr. Glicksman titled “Standardization of Bra Cup Measurements” has shown that the average implant volume required to increase the cup-size by 1 size is equal to 205 ccs. For 2 full cup sizes, it would be 410 ccs.   It is important that you communicate your goals very clearly, but understand that you need to have realistic expectations. If you did not get an opportunity to discuss the fact that you are hoping for a small D-cup, please share that now with your surgeon.  A second opinion would be best obtained through an in-person consultation, but I would like to let you know that there is no patient that does not appreciate their surgeon’s advice in the long-term seeing all the negative consequences that can happen in the short term with larger than normal implants.   Hope this helps, and best of luck!

Toronto Plastic Surgeon
4.9 out of 5 stars 458 reviews

Implant Size Choice


Thank you for your question. Your Plastic Surgeon will be recommending implants which fit your base width and will achieve the look you desire. The exact size and CC's which are ideal for everyone are different- quite individual. It will be difficult to predict bra cup size as well because there are no standards for bra sizing. My patients find it helpful to try on the implant sizers with a form-fitting T-Shirt in the office in order to get an idea of what the breasts will look like.

Choosing your size can be stressful and confusing but I recommend that you discuss with your Plastic Surgeon and trust their expertise to guide you. A second opinion would be best obtained in person.

All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Why won't my PS put a larger implant in? Is 350cc too small?

Hello! Thank you for your question. In general, implant size does not correlate with bra cup size. The cup size itself will vary from manufacturer to manufacturer as well as who is doing the actual measurements. Thus, cup size is never a reliable indicator for your breast size. I typically encourage my patients not to communicate her desires in cup size but more on the actual look and appearance.

Good communication between you and your surgeon of your expectations is warranted - choosing your surgeon wisely is the first step. Discussion of your wishes and having an honest and open dialog of your procedure is mandatory (e.g, implant type, incision, placement, lift, etc). I have found that photographs brought by the patient is helpful to get a visualization of the appearance you wish for in terms of size, shape, fullness, etc. A preoperative sizing kit is helpful in my practice. In addition, your surgeon's pre and postoperative photographs should demonstrate a realistic goal for you. Once this has been accomplished, allow your surgeon to utilize his/her best medical judgment during the procedure to finesse the best possible result for you after preoperative biodimensional planning and fitting the right implant for your breast width.  I would discuss your desires and concerns again with your surgeon. I would not proceed until you are comfortable with your decision and with the plan of your surgeon. 

Hope that this helps! Best wishes for a wonderful result!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Should I listen to my PS?

Hi and thanks for your question. Some photos would have helped. It is very important for us to follow the patients anatomy measures, if this is not respected malposition may occur. If you have doubts go and see another board plastic surgeon.
Best wishes.

Hector Milla, MD
Mexico Plastic Surgeon
4.5 out of 5 stars 34 reviews


Thank you for the question and size is an individual decision based on measurements and putting implants in a bra till you see the volume on your chest that you like.  Then your surgeon can pick the best shaped implant for that volume given your measurements.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

Why won't my PS put a larger implant in? Is 350cc too small?

Your plastic surgeon is following established guidelines for the base width of your breast.  If you were unhappy with this opinion and cecum examination by another experienced board certified plastic surgeon for an opinion.  Possibly higher profile implants may solve the problem.

Is 350CC too small?

Hi Jklila,

Thanks for your question. Some pictures would definitely help assess your breast concerns. The decision is ultimately yours. 50cc is not that much of difference but the one thing you do not want to do is get a pair of implants and then decide that you want to go bigger. I would recommend getting a couple of other opinions and unless your are 100% committed to your surgeon. If you are then trust their decision making ability.

We offer complimentary 3D imaging so that patients can see what they may look like. Its not a guarantee but it is pretty accurate and better than just trying sizers on in the office. You get to see the real you and not someone else's breast on their body.

Remember that there are also ultra high profile implants that may fit into your chest. Discuss with your surgeon. Good Luck!

All the best,
Carlos Mata MD, MBA, FACS,
@breastaugmentation @SiliconeImplants @docmata #drcarlosmata
Board Certified Plastic Surgeon

Carlos Mata, MD, MBA, FACS
Scottsdale Plastic Surgeon
5.0 out of 5 stars 30 reviews

Tradeoffs of breast augmentation

That is a great question.  When selecting an implant for breast augmentation it's important to understand the tradeoffs.  My bias is that any plastic surgery should look natural.  So the width of your existing breast and the distance from your breast fold to the nipple on stretch helps to determine the size of an implant that will "fit" and appear proportional and natural for you.  Implants that are too large for a given patient may make you happy at first but can cause too much stretching of your breast and lead to  problems down the road that are difficult to fix.  They can also look out of proportion with your breast and frame and appear unnatural.  And I see many patients who start to have back and shoulder pain as the breasts get into the D cup size and they want to be smaller.  If you are not comfortable with the implant that is recommended, go back and have a conversation with your board certified plastic surgeon to discuss this further. 

Jonathan Hall, MD
Boston Plastic Surgeon
4.9 out of 5 stars 34 reviews

Breast A

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
Director-Beverly Hills Breast and Body Institute

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 91 reviews

Breast implant size selection

Thank you for asking. Breast implant selection is an important decision. The collective picture of a patient's goals and body anatomy need to fit. Too large or too small an implant will either over stretch to bottom out or underachieve the patient's goals. It's important to realize that proper suzing can only be done after being seen in person and only you PS has done that here. Ask for an understanding of why 350 cc is being chosen for you. Always see a board certified plastic surgeon. Hope that helps- best wishes!

David C. Yao, MD, FACS
Phoenix Plastic Surgeon
4.8 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.