Can't decide on a size and why my doctor wants to have same cc in both when clearly one is bigger and lower? (Photo)

Hello, Ian getting Natrelle Inspire 375cc , 4.3 projection .... I am 5.7 tall and I have an athletic body ... Just wonder if I should go with a higher CC ... I read all those stories that if you're tall and have while shoulders ... You need to put over 400 Cc .... I would like to end up a full C or a normal D . Also in order to be symmetrical i think that the CC in both should be different . Can you please advise ? Thank you

Doctor Answers 4

Uneven breast size and breast implants

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You've asked a very good question.   Like the other surgeons, I agree that using different implants is not always the best course.  I find that sometimes one breast may be more droopy and appear larger but actually have a fairly similar volume to the other side and using equal implants is best.  At other times a different size is best however that creates a difference in the width of the implants that may or may not be acceptable.  Cutting a hypothetical 35% asymmetry in volume to a !0% asymmetry with similar sized and dimensioned implants is often the best choice as your breasts are tripled in volume (or more).  I also explain to my patients that in my experience in 80% of patients, making breasts larger seems to make the asymmetries present "less important," though in a small percentage it may leave it visually unchanged or even exaggerate it.

In your case and only based on your photo I would think that approximately a 375 cc implant or perhaps slightly larger would give you good proportioning however, I would have my patient consider a Benelli mastopexy to decrease (and prevent an increase) your areolar diameter and raise your left nipple to a closer position to the right side.  Such maneuvers during surgery allow what I consider the best aesthetic result by allowing adjustments to nipple position, implant position and implant size during the procedure.  For that reason I and others choose not to preselect an implant before the procedure.  Perfect symmetry is very rare but improving each breast to the degree possible requires intraoperative flexibility and artistry on the part of the surgeon.

Beverly Hills Plastic Surgeon
5.0 out of 5 stars 33 reviews

What size implants

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 In my experience, I have not found any magic formula based on the patient's height or weight that will best predict which size implant would look best or what bra size the patient will end up with. There are so many other variables such as the amount of overlying breast you already have, the compliance of the soft tissues, and the location of the nipple  and areolar  complex relative to the crease that contribute to the resulting size and shape of the augmented breast.  As far as symmetry goes, if the natural breast is only off by a little bit as you put a larger and larger implant in the contribution of the breast that off becomes less of a percentage of the total. That's strictly a judgment call based on size of implant. Vector 3-D imaging helps a lot in this regard. Good luck with your surgery.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 58 reviews

Would I benefit from differently sized breast implants?

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First, ignore most of the stories you hear on the internet because most of them are just...stories.  To choose an optimally sized breast implant, consider the following variables:

  • Your height
  • Your weight
  • Your body type 
  • Your breast tissue quality
  • Your desired cup size

With these variables in mind, you and your Plastic Surgeon can generally identify a size range that will help you achieve your goals.  You may notice that I said a "range" and not a "size".  As a Plastic Surgeon, I was taught to identify a specific size during the initial consultation.  But after over a decade of performing high volume breast enhancement procedures, I found that a single size just didn't cut it.  Instead, I work with my patients to identify a size range and then use sizers (placed within the pocket where the implant will eventually sit) to actually see exactly what a certain volume will help achieve.  In my mind, this is the only way to really nail down the most optimal implant size and identify how your tissue will respond to it. 

As for placing differently sized implants, I do that all the time and find that most women are asymmetric when it comes to their breasts.  From your picture, I might suggest a range of 375-425 cc to give you a C/D cup but I also might recommend a breast lift since your nipple position appears to be a little low.  

I hope that helps and wish you the very best with your surgery!

Implants and symmetry

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Your question is common but I will attempt to explain why perfect symmetry is not possible and different implant sizes may or may not help.

In large differences, a different size implant may be necessary.

In small differences when the shape of the breast is different that might not be the answer.

You are visualizing the procedure as the end result, or attaching new breasts outside your existing breasts to end up with perfect breasts.

In reality the implants are placed inside your skin envelope rather than added to the outside so that if the skin envelope is different the results will be different. 

Reasons why there is not symmetry
One breast has more droop. The implants will not add to the bottom half of the breast. They tend to add to the upper. The way to correct droop to make things even is a lift, but then there are scars and more cost. If the droop is minor it is usually not worth the scars to even them out.

One breast is wider. Many women the left chest is wider than the right. The heart is on the left. As surgeons we cannot make the chest wider or narrower. A larger implant on the narrower smaller side can look worse. Kind of like a toothpaste tube, it pushes out and looks worse above in a bra.

The best way to correct assymetry is an adjustable expandable saline implant like we use in breast reconstruction, but the disadvantages are cost, rippling, possible multiple procedures, feel and rippling of a saline implant unless you have a second operation for a gel.

The cohesive gel gummy bear implants have the best results of molding to  your breast.

Remember if you are larger and even if the same size implant is used, you will be closer. In other words if your breasts are 150 cc on the right and 200 on the left and you add 400 cc 550 and 600 are closer than 150 and 200. But some patients notice their differences more after surgery, or are expecting perfection like buying a new iPhone out of the package.

Size of the implants depends on width of the chest, not the shoulders. Then the skin laxity and patient desires determine the projection. The projection and width determine the implant size or cc then.

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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.