Will I wish I had chosen a larger implant size? The next size silicone implant was WAY too big but these are too small. (photo)

Question

I tried on silicone cups at my pre-op appointment. I went with 505ccs. I definitely want large enough breasts that others notice but not so big that people stop and stare. After hearing that everyone wishes they went bigger, I'm concerned that I will wish that I had gone bigger, too. They look great in the photos but I feel like they could be just a bit larger. Im just wondering if I should contact my doctor and request to go slightly bigger before my operation. How will my post op compare?

Richard H. Tholen, MD, FACS · Answer

Since you haven't had surgery, you haven't "chosen" your implants yet. Unless, of course, your surgeon has to order the size you choose ahead of time. Plus, is your surgeon accommodating submuscular compression by adding about 10- 15% to your chosen size when sizing? If you liked the look of 505cc, I would use around 575cc implants in the operating room. If your surgeon implants the same size whose "look" you liked in the sizing room (505cc), you WILL be disappointed (too small). After 27 years and thousands of BA patients, how do you think I know this fact?In our office we maintain an extensive inventory of both saline and cohesive silicone implants in all sizes and profiles, so we never have to "order a few" in advance of your surgery. That way our patients can decide right up to the day of surgery--a few even re-size on the day of surgery! And if one doesn't look "right" after I insert it, I will have the proper one right there on-site, and would not hesitate to change it. Most surgeons use the choose-it and use-it or you buy another pair of implants and a re-do operation later!Also, you should understand that the next implant size up from your 505cc sizer is probably around 550cc (depending on implant manufacturer and profile required by your anatomy). That is a barely-visible increase--45cc is only 3 tablespoons! Your doctor's sizer choices may not have been complete--implants don't come in small, medium, and large; they have 30cc increments on the smaller implant end of the scale, 40-50cc increments in the midrange sizes, and 100cc (less than 3 1/2 ounces) increments at the largest sizes. We have a complete set of sizers as well, making choosing the exact size that is right for you much more easy than just having a few sizers or resorting to rice bags.Bottom line here--you need to re-size and decide what you want. Ask about adding a bit to compensate for submuscular compression, and make sure the profile chosen is the maximum width to best fit your pocket--otherwise you end up with HP implants that leave wide cleavage and less upper pole fullness (once they drop). Or get a few more consultations so you are comfortable with the process. You may want to  obtain additional information available by clicking on the web reference link below for my Comprehensive Guide to Breast Augmentation. Best wishes! Dr. Tholen

Christopher J. Davidson, MD, FACS · Answer

There should not be a tremendous issue of difference between
adjacent implant sizes.That being said,
if you ask 100 women one year after breast augmentation surgery, did they like
the size they chose, did they wish they went smaller, did they wish they had
gone larger, more than 50% will say they wish they want bigger.Just so that you keep in my mind.That being said, 505 cc implants are
certainly sizable.Best of luck.

Josh Olson, MD · Answer

It really is difficult for anyone online to give you sound advice without examining you and knowing your measurements. Just with your height I would think you are going large as it is and I personally would probably advice against going bigger but without speaking with you in person this is just general advice. The sizers that are over 450cc are flatter than the implant your surgeon may use if he/she goes with a high profile implant so hopefully you trust your doctor and discuss your concerns with them. good luck

Gary Lawton, MD, FACS · Answer

The
best way to determine the size for your personal perception of the perfect
breast is to try on sizers.   This way you can see how they fit on you,
how they add to your current volume, and whether they fit your frame.
 Although the surgeon can guide you, only you will be able to tell what is
the right size.  Try on sizers.  If the sizers look a little too small for you you will be disappointed because after all is said and done, the implants look a little smaller than the sizers.  Best to cll the doctor ahead of time.  We have multiple pairs of every size implant so you can make a change in size on the day of surgery.  Most every other surgeon orders implants for you so there is no flexibility on the day of surgery. If you are already concerned, go a little larger.  I have never seen a patient with implants who complained of shoulder or neck pain.

Heather Rocheford, MD · Answer

First of all thank you for the question and the pictures.  If you are unsure of the size you have picked, I would strongly recommend a re visit with your surgeon to discuss your concerns.  It is very difficult to give you sound advice on implant size with out examining you. Best of Luck!

Connie Hiers, MD, FACS · Answer

I would suggest going back to your surgeon and discuss the size again.  Try on different sizes to see what look you prefer. Try not to go too heavy for your neck and shoulders, and past what your tissue will support.  Your surgeon can help guide you to the best size.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. Unfortunately, online consultants will not be able to provide you with specific enough advice (regarding specific breast implant size/profile) to be truly helpful. Given that your surgery is coming up soon, I would suggest that you spend more time with your plastic surgeon communicating your goals carefully.
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. In bra sizers can be useful communication tools also. 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 who makes the bra; therefore, discussing desired cup  size may also be inaccurate.  The use of computer imaging may be very helpful during the communication process.
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.

M. Dean Vistnes, MD - Account Suspended · Answer

Yes, schedule an appointment to try on sizers again. If you are working with a board certified plastic surgeon with an expertise in breast augmentation he or she should be able to help you with your decision. Good luck! best, Dean Vistnes, M.D

Ronald V. DeMars, MD (Retired) · Answer

It sounds like you need to see your surgeon again for further discussion before surgery. It is not possible for any online consultant to give you any advice on implant type or size without an exam.

Will I wish I had chosen a larger implant size? The next size silicone implant was WAY too big but these are too small. (photo)

Answers (9)

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