Is my Recommended Implant Size Too Large?

My surgeon recommended a size 400 implant filled to the min of 400 CCs. I went to another consultation with a diff surgeon and he suggested 360 filled to 390. That reassures me that my CCs are correct for what I want. My measurements are 12.5 on one side and 12.7 on the other. I'm worried that a 400 implant filled to 400cc will cause wrinkling since the implant is not completely filled. I am getting saline implants. is 400ccs too big for me? I am getting moderate plus. I am 21, 5'7", and 130lbs

Doctor Answers 12

Implant Sizing

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Hello OklahomaGirl,

Please heed all that was said by Dr. Tholen, he hit all the points well.  If money is an issue, than you'd be better off with smaller, non-high profile saline implants with a diameter nearer to 12 cm.

Best of luck!

Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Filling Of Saline Breast Implants

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Given that you have had two consultation with virtually the same size selection, then you know that they are not too big for you. The more significant question appears to be whether saline implants should be overfilled or not. Given the end goal of 400c in size, I would choose a smaller implant (350cc) with a high profile and fill to 400cc. In my experience that is the most likely to end up with the least amount of rippling. But remember, no matter how it is done you will have some rippling in your saline breast implants. That is an unavoidable aesthetic feature with their use.

Implant types

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There are many different shapes of saline implants available, but I my experience, high profile implants placed under the muscle tend to ripple the least.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Filling of saline implants

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I think the real question you are asking has to do with over-filling of saline implants. Saline implants are designed to have an optimal range. I generally fill close to the upper limit. I have not found that it increases any rippling. I am not a fan of over-filling. The more you over-fill an implant the more firm and round it gets. It also produces more scalloping at the edges. The implant profile can then be chosen to fit the desired fill size. Good luck.

Breast augmentation and best implant size

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With regard to what size breast implant is best for you, only you and the surgeon that examined you can make that determination.  In my practice I have patients try on the various size and shaped implants, in a bra.  I counsel them that the implants will appear a bit smaller, after the surgery, when they are under the breast tissue.   When trying to decide between two implants in which the option is slightly underfilling one vs. slightly overfilling the other, I would usually suggest the later, for the reason you mentioned.  Please note that the ten CC difference that you are concerned about, is so small, I doubt you would be able to tell the difference between the two.  Best wishes.   

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.7 out of 5 stars 63 reviews

Size may be fine, but fill is not, and silicone avoids both rippling and deflation issues.

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Thank you for including detailed information, but realize that breast base measurements are going to be different depending on each surgeon's "method" of measurement, since breasts do not have "sharp" edges, especially laterally where the breast flows into the chest wall, and often medially near the cleavage area as well. Choice of profile depends on this measurement, or more accurately, the dimensions of the actual submuscular pocket, and the desired implant volume you and your surgeon choose to fit your goals and anatomy.

But 400cc in a 400cc implant is an error, IMHO. "Overfill" is a misnomer, since proper fill is actually about 10% more than the actual stated saline implant volume. This is because saline implant shells are manufactured using the same-size silicone gel mandrels, but obviously are not filled with the cohesive silicone gel when sold as saline implants. Since saline has a significantly different viscosity than silicone, rippling that is not seen with, say, 400cc of silicone gel will very commonly be visible with 400cc of saline in the same implant. 430-450cc reduces the rippling significantly but does not cause true overfill scalloping, change filler valve competence, nor does it void the implant warranty. Several studies also confirm that a 400cc implant filled to 400cc total volume will have a higher leak and deflation rate than the same implant "overfilled" properly to the volumes noted above, and chosen by the surgeon at the time of surgery dependent upon your muscle tone and tissue coverage.

For your height and weight, these implant volumes (around 400cc) seem about right, but trying on implants in a bra and stretchy top is one good way to see if you're in the right ballpark, and bringing your surgeon goal photos of breast size you think are good will also help this decision. The difference between 360 and 400 cc is less than 3 tablespoons of volume, so this is immaterial to your final look.

Much more critical will be the rippling you would likely see with a 400cc implant underfilled to 400cc! 360cc filled to 390cc is a better plan, and this surgeon at least has saline "fills" right.

But why are you not considering silicone gel implants? These are cohesive and cannot leak. You do NOT need an MRI every 2-3 years if you are having no issues or concerns with your implants (and if you do, you need to see your surgeon who can examine you and determine the best recommendation as to the best way to correct your issue or concern). This may well require a revisionary surgery, but wasting money, time, and over 20% false "rupture" diagnoses with MRI is NOT recommended, IMHO. Silicone may cost a bit more than saline on the front end, but think about what a second surgery for rippling or deflation costs, not only in $$, but also in time off work, etc. And silicone is softer, more natural in feel, and much more homogeneous with breast tissue. All of this = "better" for the vast majority of patients.

For more information about the safety of silicone implants, click on the web reference link below. Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews


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It’s very hard to say whether the implant would fit your body without seeing you and or examining you. It has a lot to do with your body structure. In our practice we tell our patients that 200-225 cc equal to about one cup size.


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

What do you want to look like after breast augmentation

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You can guess about numbers, but it is impossible for us to say what might be too big or too small unless we see the volume and skin envelope of your breast, and what you wish to look like. The fill range will be fine 400cc or a bit more will not produce a ripple, though under fill can reduce the implant life, as can overfill. Worry more about how you wish to look unless you want to toss the coin and see what happens. The number you will forget, how you look you will not.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Is my Recommended Implant Size Too Large?

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I think most of us like to fill a saline implant beyond it's minimum size as you have heard from other consultants on this site. As to whether or not that is the right size in your case, it would be impossible to give an accurate comment without an exam. But you have had two exams and both doctors were in the same ballpark.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

Size , to fill to the minimum or maximum

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As far as how much to fill in an implant I would generally fill to the higher range that is listed on the implant box because of rippling and a chance of an underfilled implant if you only place the minimum.

As far as the size , based on the base width diameter both implants mentioned are reasonable but without an examination the exact fill is hard to determin.  

Walter D. Gracia, MD
Fort Worth Plastic Surgeon
4.7 out of 5 stars 3 reviews

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