6 Months Ago I Had Mentor 325 Cc's Smooth Round High Profile Silicone Breasts Implant Surgery, I Am 5' 4"

Question

110 lbs. small frame and very athletic and feel they are too big for my lifestyle. I asked my Dr. what 325 cc was equal to in bra size prior to the surgery and was told it was equal to a small to medium B cup. I only fit in full c sized bras and would like a reduction but don't know how much less. Medium B bra cup is fine with me and I was happy with that. Can you tell me what size is more in line with a medium B cup and any recommendations regarding my options going back in for surgery so soon?

Frank Agullo, MD · Answer

The general rule is that a cup size is between 150-200 cc's. If you were an A cup to star with, a 150-200 cc implant should have gotten you to your desired B cup. You should wait 6 months before having any breast revisions or surgery, since the risk of complications is increased if surgery is done prior to this. Patients should try on different implants before undergoing breast augmentation. A good conversation with your surgeon should guide you towards making the best decision. I like to use the Vectra 3D system, so that patients can visualize their results prior to having the procedure.

Tom J. Pousti, MD · Answer

Thank you for the question.

	The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size.  Much of the final &ldquo;look&rdquo; achieved after breast augmentation surgery  depends on several factors: 
	1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation &ldquo;look&rdquo; will be optimal.
	 2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.
	 3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result. On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants. Other differences involve how the breast implants are filled. Saline implants are filled after they&rsquo;re implanted, so saline implants require a smaller incision than prefilled silicone breast implants. On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers&rsquo; saline-filled breast implants are considered investigational. As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
	 4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of &ldquo;goal&rdquo; pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as &ldquo;natural&rdquo; or &ldquo;C cup&rdquo; or "fake looking" or "top heavy" 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. I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. By the way, the most common regret after this operation, is &ldquo;I wish I was bigger&rdquo;.
	 I hope this helps.

Glen Brooks, MD · Answer

It is difficult to predict what cup size a patient will be following breast augmentation. Preoperatively, many surgeons will simulate your new appearance by placing rice in bags or using implant sizers in a sheer bra. Computer generated images may also give some idea. High profile implants are best reserved for narrow chested women looking for a larger than average size implant. Many patients note they can have a less thatn "natural" appearance since they are quite round and projected. The average patient will increase one cup size for every 200 cc of volume. This would be more for a petite individual and less than a cup for a larger female. Generally, patients will increase or decrease 100 cc for a noticeable difference.

Peter E. Johnson, MD · Answer

You can go down to a smaller implant safely, and my feeling is that the high profile implant is part of the problem. The HP style is like what we used to refer to as a grade I capsular contracture where the implant just starts to round up a bit. You might feel better in a moderate profile 275cc implant which will spread the implant in a more natural way within your breast. You could even go to 200cc if your goal is to be smaller and still look well.

	Best of luck,

	peterejohnsonmd

Kamran Khoobehi, MD · Answer

You can ask your surgeon about his recommendations after examination. We do not have access to pictures or dimensions. I would recommend going at less 75-100 cc smaller.

Adam Hamawy, MD · Answer

It is very difficult to promise or guarantee a cup size after breast surgery. That holds true going bigger or smaller in size. Good communication with your plastic surgeon is key in order for him or her to have a good sense of what your desired results are. You can certainly decide to replace the implants with smaller or larger ones if you are unhappy with your current size but due to all the variability in bra manufacturing and cup sizing, the cup size should not be your ultimate goal. Set your goals to be breasts that you are comfortable with, that fit your lifestyle and will not cause harm in the long run.

Paul C. Zwiebel, MD (retired) · Answer

There is no easy way to predict bra cup size precisely, but for a woman your size and implants you currently have, an approximation is a reduction of 100cc (+/- 25cc) will produce a one cup size change.

	If the implants are saline, some surgeons will perform progressive deflation with a needle and syringe as an in-office procedure, if you are committed to removing your current implants. Puncturing the implant will cause complete deflation over a few days, but while you are in the office, the surgeon can withdraw incremental volumes as you view the change. In this way you can determine exactly how much smaller the new implant should be for the look you want.

	Of course, this can't be done with silicone implants.

	Consult with your surgeon to see what technique he prefers to help you determine the best replacement size.

Robert M. Grenley, MD (retired) · Answer

Bra cup sizes are too variable among manufacturers to be able to predict. I stay away from predicting or promising cup sizes based on a given implant size. I have my patients try sizers on in a stretch bra to get an idea how much volume that will add to the breast tissue they already have, and they choose the implant volume that best fits their goals. High profile implants are more projecting or protruding for a given size, and unless you have a very narrow breast and chest wall, I think a moderate plus profile implant would give you a more natural and less projecting shape, but again I do not have examination or photos to go by in your case. I would think that a 75-100cc reduction in implant size, down into perhaps a 225cc implant may give you a size you would be more comfortable with, assuming you don't have very loose skin from pregnancies and nursing that you are trying to fill out.

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