Need help deciding between 325cc or 295cc? (Photo)

Question

I’m 25 years old 5 feet and 100 pounds. My breast width is 10 cm and my current bra size is 32AA. I am having my surgery in July and I need help deciding which size of implants to choose. I would like to have a full C but not a D. When i put on 325 cc it was kinda big, and the 295 was perfect. So if i liked the look of 295 cc hp when i tried it should i get a size bigger as the nurse said they will look smaller in the breast?

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your questionAfter performing hundreds of breast augmentations, I have found that 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. Implants that are wider than this can be more palpable, fall more laterally overtime and also be more palpable. After that we will then choose the implant volume based on the measurements and also looking at any asymmetries you might have. You should choose a board certified plastic surgeon that you trust to help guide you in this decision. Bringing photos as well can help us to finalize, but please understand that these are of other peoples bodies and your results will probably be different.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 softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured. Anatomic gummy bear implants might be a good choice to give you a more natural look. 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. Implants, indifferent projections. The easiest way to think about it is they called me in a low medium and high projection or profile. Most of the time I use the medium profile which gives people the best in terms of natural look as well as a little bit of projection. High profile implants are for someone that wants  A little bit more of a fuller look. Low profile implants are better for someone that really wants a minimal extremely natural augmentation. Depending upon the anatomic versus round implants there are also subtle differences  in terms of the amount of projection for each profile. 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. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.In order to limit pain from breast augmentation and speed the recovery process I offer patients Botox into their muscles as well as a long acting numbing medication called exparel. 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 SchwartzBoard Certified Plastic Surgeon #RealSelf100Surgeon#RealSelfCORESurgeon

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well..based on the photos shown, the ideal is that to determine the size you are consulted in person by your plastic surgeon and see how many cc you can get the result you want and what technique you apply.

Trevor M. Born, MD · Answer

Dear melancholicmissyThank you for your question!  The size difference between the implants is 10 % of the volume- so there is little risk with going with the larger implant. The remaining question is the implant placement - above or below the muscle.With Warm RegardsTrevor M Born MD

Elisa A. Burgess, MD · Answer

In my practice, we tell pts that 30cc is not much of a difference. Typically silicone implants look smaller once they are inside the body so pts usually chose the slightly larger implant. We have Crisalix in our practice to help with 3D imaging with different sizes of implants in the consultation appointments. This allows patients to see what they may look like with different sizes. We even have virtual reality goggles so that you can look down at yourself with the different sizes. Good luck with your surgery!

Alfred Sofer, MD, FACS · Answer

Thank you for your question. It is difficult to make a recommendation about size of implants without a proper consultation. Many board certified plastic surgeons offer technology that can do 3D simulation breast imaging so patients can view outcomes not only related to their breasts, but to the entire body as well. I recommend discussing these options with your board certified plastic surgeon, who can individualize your treatment plan.

Kenneth Hughes, MD · Answer

The difference in 325cc and 295cc is imperceptible to most observers.  I think that if you have the decision down to a volume disparity of 30 cc, either implant will produce a similar result.  Also, remember that any implant placed under the muscle is blunted.  So, anything you think that looks good when you are sizing prior to surgery -- add about 50 cc to that.  I would recommend that you go with the size that boosts your self-esteem, and fits your anatomy.
Kenneth Hughes, MD, Board Certified Plastic Surgeon
Los Angeles, CA

Donovan Rosas, MD · Answer

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. This will ensure that you avoid the dreaded "fake" look. 
With regards to your specific questions, I would not stress over a 30 cc differential. This amounts to a few teaspoons or less than the volume of a shot glass. This is unlikely to make a significant difference in your result. If you liked the look of the 295 cc implant best I would recommend sticking with your choice. That being said, you should be happy irrespective.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Daniel Barrett, MD · Answer

Dear melancholicmissy,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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nancy de Kleer, MD, FRCSC (Plast) · Answer

With your body frame and the desires you express for your look, I would recommend the 295 implant.In my office we use a sports bra to help with selection of implant size, and the compression from the bra comes very close to the final surgical outcome.Also, feel reassured that the difference between 295 and 325 is not a large difference, and so it is possible you would be satisfied with either of these.  If you feel the 325 was too large, go for the smaller.  If you are concerned about not going large enough, go for the larger, provided your surgeon agrees that both implants are acceptable for your tissues.All the best to you,Dr. Nancy de Kleer