How many CC's should I get if I want to be a full D? (photos)

Question

I wear a size 40D braw, I'm having a breast lift and silicone implants. The doctor said 400 CCs but now i think i will end up looking too big with 400 ccs. He said my rigth boob is smaller then the left one and i will lose some tissue with the lift.

John Michael Thomassen, MD · Answer

If you are concerned about your final size, try the implants on first.  This should give you an idea of what volume you will end up at.  Your surgeon can then do the augmentation first and then perform the lift around this selected implant.

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link.

Kenneth Hughes, MD · Answer

I would probably offer you breast augmentation and a vertical lift.   I would try on sizers in the office to determine how large you will appear with the implant.Kenneth Hughes, MDLos Angeles, CA

Richard H. Tholen, MD, FACS · Answer

A properly-performed breast lift will entail the removal of no more than an ounce of skin per breast. It remains a mystery to me that some surgeons actually recommend removal of normal breast tissue in order to use large(r) implants. If your breasts are the size  you want, a full breast lift will require the removal of no more than one ounce (30g) per breast, and no implants would be needed. But if you want to go up in volume with your lift, realize that there are anatomic limitations since the skin removal necessary to lift and shape your breasts will now be asked to "contain" even more volume. This can be potentially disastrous, if too large and too tight causes wound breakdown, inadequate circulation leading to dead skin, or loss of implant due to exposure! (All major problems).I believe that adding 400cc (anatomy allowing) will add about 1 1/2-just under 2 bra cup sizes to what you already have at the present, assuming your surgeon removes just that ounce of skin to do your lift. Asymmetric breast sizes can be dealt with via different size implants. If the discrepancy is visible in a bra, this is at least 60cc; if it is about half a bra cup size, then it is more like 100-125cc. Make sure this estimate is as accurate as possible or the implant difference will not adequately deal with this.To decide if you will "look too big," first ask your surgeon how much tissue he typically removes during breast lift, whether or not he plans to remove more tissue from the larger breast to accommodate the asymmetry, or if he plans on two different implant sizes. Then try on implants in a bra and stretchy top and see how you look. Choose carefully! Then realize that your surgeon should use about 10-15% larger implant than the ones you chose, in order to accommodate for submuscular compression that will make you look smaller than you sized. Best wishes! Dr. Tholen

Rian A. Maercks, MD · Answer

The most important part of your procedure is a well executed lift and appropriate planning with the augmentation.  My strong preference would be a vertical lift with a Cold-Subfascially placed form stable anatomic implant.  the exact size and shape needs to be selected by a surgeon experienced with these techniques and devices.  I would guess somewhere around 500 cc would be appropriate but would need more information to comment exactly.  I hope this helps!All the best,Rian A. Maercks M.D.

Mel T. Ortega, MD · Answer

Thank you for your question.

Based on your photos I believe you are a
great candidate for a Breast Lift with Augmentation, I will recommend 300cc,  this will give you the
look you desire.

Many surgeons offer online virtual
  consultations where you send your photos and medical history information so
  that you can receive accurate cost at no cost to you.
Choose a board certified plastic surgeon who has done a ton
  of Breast Lifts and has privileges to do this surgery at a local
  university hospital. This says his credentials have been checked out by
  fellow Drs. All surgeries carry risk, talk to your plastic surgeon and choose
  one wisely.

J. Garrett Harper, MD · Answer

You wear a D cup now and you want to remain a D cup?  Why are you getting implants then?  A powerful lift should get you a beautiful result.  I would consider doing the lift by itself and seeing how things go.  If you need more volume then you can always go back and add a submuscular implant at a later date.  I have often found the by doing a lift, my patients end up so happy that they don't get the implant.  You could also do some fat grafting down the road or at the time of the lift to add some volume and even things out.

Darryl J. Blinski, MD · Answer

The real issue is your chosen surgeon going to be able to close the vertical incision with to large an implant? At 400 ccs I think risky. In cases as yours I offer two operations. A lifting first than 3 months later a larger implant from 400 to 600 ccs as needed after trying on sizers with the new elevated breasts... Just another way of doing your procedures /

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.  As you may be aware, there is no accurate correlation between size of breast implant utilized and specific cup sizes achieved. I would strongly suggest that you do not communicate your goals, or judge the outcome of the surgery performed, in terms of achieving a specific cup size. When performing a breast augmentation/mastopexy procedure, I use a “tailor tacking” technique that allows a determination of what breast implant should be used to SAFELY produce the results the patient is looking for. This technique involves use of a temporary sizer and temporary “closure” of the overlying breast skin over the sizer. 
The use of the tailor tacking technique is very helpful.  Breast lifting involves removal of skin ( and tightening of the breast skin envelope)  while breast augmentation involves expansion of the breast skin envelope. These 2 forces are counteracting each other. Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate  size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications.  I hope this, and the attached link (dedicated to  breast augmentation/lifting surgery concerns) helps. Best wishes.

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