Breast augmentation - choosing the implant
Thank you for asking about your breast augmentation.
- Your goal seems reasonable but it is hard to predict cup size with implants.
- In general, for your height, a 300 cc will be a B, a 350 a full B or C, a 400 a small D/D.
- But there are lots of variations -
- Your surgeon will do measurements and make recommendations.
- You can do a lot as well to figure out the right look for you.
Always see a Board Certified Plastic Surgeon. Best wishes - Elizabeth Morgan MD PHD FACS
Hi SiliconeGummy, I agree. Personally I would prefer silicone, and even though we let our patients pick implant type, about 95% pick gel. Here are a few tips for you because this is perhaps the hardest decision for a patient to make, as well as the surgeon. Also see the video attached to my answer. We spend up to two hours for our BA consults to be sure there is careful communication. We do a full exam in front of a full-length mirror taking six exact measurements. We put your photos on a large computer screen for imaging, and go over your “ideal-size” photos. We then save this information to your password protected “web account.”
First and foremost the implant should fit the dimensions of your breast and tissue cover. Balancing the implant to your over-all body shape and tissue cover is essential. The main thing is to have the diameter of the implant fit the diameter of your breast "foot-print". Higher profile implants tend to have a smaller diameter. Higher is really a marketing term, but often translates into the same volume implant with a narrower base. Saline implants actually tend to decrease in diameter as they are inflated! The average size chosen over our last 7,000 breast implants was “350cc”. BUT, 90% of our patients tell us they wish they were bigger a year after BA. (We will see you every year for routine checks at no charge.) It’s like your mind incorporates the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients that they will experience an increase of approximately one cup size per 200 cc. You can try on implants in the office by placing them into a special bra. The implant is also flattened somewhat when under the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for flattening of the implant in the partial sub-muscular pocket. Once you decide on a size you like, then add on 25cc, because in real life the implant will be flattened slightly by your tissues. Multiple measurements need to be taken to fit an implant to your exact anatomy. Have your surgeon's office show you the charts of the implant dimensions for the various profiles of silicone and saline from the manufacturer. Then you and your surgeon can piece together the puzzle by matching your measurements, with your wishes, versus your tissue cover and the available implants to arrive at a surgical plan. Keep in mind larger implants tend to have more problems over the years. Since silicone implants wrinkle less than saline implants, they might be your best bet.
You can also approximate this at home by measuring out an equivalent amount of rice placed into a cutoff foot of old panty-hose, and put this in your bra. Wear this around the house for a while, and see what you think. Implant size must square with assessments of tissue cover, breast diameter, and chest wall width. Multiple measurements of your chest wall are taken (seven in total). Implant size selection has been an issue of much discussion.
Therefore, I use a wide variety of methods, but the implant size is always established preoperatively. Also, patients are advised to bring reference photos demonstrating their ideal size and shape. A photo album of patient pictures is maintained to assist them. These photos ultimately help in determining where the implants will be placed, since they can be shifted inside (to provide more cleavage), to the outside, up or superiorly, and down or inferiorly during surgery. In determining the final size selection, I always place the highest priority on the preoperative measurements and potential tissue cover. Finally, your verbal requests are factored into the analysis.
We use the quick-recovery approach, so click on the web reference link below to have this explained and you can see the list of Quick-Recovery (Flash-Recovery or Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery journals. It is a surgical procedure that uses special instruments and techniques to minimize tissue damage and avoid touching the ribs. It causes far less trauma to surrounding tissue than traditional approaches, and it dramatically reduces pain and recovery time. In published studies of BA patients, 95-percent of women interviewed after the procedure returned to normal daily activities within 24-hours. Quick-recovery BA is not a “gimmick.” These specialized techniques, which actually speed recovery and get you back to your daily routine, kids and work, are published in our plastic surgery journals. Because these PS journals are “peer-reviewed” and edited, they are the gold-standard in our field as being valid science. Therefore, these are sound techniques, not marketing hype.
Be sure to see only a board certified plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member of ASPS (The American Society of Plastic Surgeons). Also, ask if the PS has an established, high volume breast augmentation practice, performing several hundred breast augmentations each year. Be sure the PS has been in practice for a while, about 20-years might be a good gauge. Does the PS offer all three incisions? Discuss the implant type (gel or saline), shaped "gummy bear" or non-shaped, smooth or textured, implant pocket (over or under the muscle) and the "quick-recovery approach." Ask to see their before and after photos if you didn’t see any on their website. If they are experienced, they should have several 100 breast implant patients for you to view. I would also recommend that your doctor offer you the chance to talk to past patients who would be happy to discuss their experience with you. You need to feel comfortable, so make sure the environment is safe as in an accredited surgery center. Also, ask a prospective surgeon if he or she has ever published journal articles in professional peer-reviewed journals, which they can provide you.
All the best, “Dr. Joe”
I am 118lbs and 5'6 tall. I am currently a 32A cup barely. I want to get a BA, but what size should i get? I do not want saline.
Hello dear, thanks for your question and provided information as well..
The breasts may lose their elasticity and firmness which can be caused by different factors such as pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts and restore the natural look your surgeon can perform a mastopexy or breast lift. A breast lift restores a firmer, perkier, and more aesthetically pleasing shape to sagging breasts. This not only can improve a patient’s appearance by restoring her youthful, feminine proportions, but also help bras and swimsuits fit more comfortably and attractively. By removing excess, stretched out skin, reshaping the breast tissue, and raising the nipple & areola into a more forward position, a cosmetic surgeon can create a more youthful breast contour. Stretched, large areolae can also be reduced during breast lift surgery, creating an overall better proportioned, natural looking breast, Actually the perkiness on a person or another, depends on patients skin and breast tissue… Breast augmentation surgery increases or restores breast size using silicone gel implants, saline implants or in some cases, fat transfer. One of the most popular and frequently performed aesthetic surgery procedures, breast augmentation has a long and successful track record in satisfying women who wish to enhance, regain or restore balance to their figures.
Silicone implants, some advices:
Thanks for the question.i recommend you change them for Cohesive Gel - Silicone Breast Implants with textured cover ("gummy bear implants").
They are quite safe and aesthetically best as they give a firmer consistency, better projection and most natural appearance than Saline implants.
Dr. Emmanuel Mallol Cotes.-
Hello,Implant size is a matter of personal preference and what your frame will support. In our practice we offer Vectra 3-D computer imaging so that you can see a very good representation of what your result will be for various implant sizes. A consultation with a board-certified plastic surgeon can help you make a decision and if that surgeon offers Vectra imaging, it's a plus. Good luck.
Hello and thank you for your question. The size 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.
Harvard-trained plastic surgeon
Want to get a BA, but what size should i get?
The best cosmetic result in any
particular breast augmentation patient depends on a variety of factors,
including: your individual anatomy, realistic expectations, a thorough
discussion with the plastic surgeon about the options, and an understanding of
the pros and cons of any particular implant choice. Proper sizing is not just
about the number of cc’s. The thickness of your tissue, breast dimensions which
include the width, height, and projection, as well as chest wall width all need
to be considered when choosing an implant. Trying on implant “sizers” of
various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit
at a preoperative visit will help you and your surgeon choose the optimal
There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 32 D and a 36 D are significantly different. Cup size
varies from manufacturer to manufacturer and even within styles from any
particular manufacturer. There is no direct correlation between implant number
of cc's and cup size in any particular patient.
Keep in mind that following the advice from a surgeon on this or any other website
who proposes to tell you exactly what to do without examining you, physically
feeling the tissue, assessing your desired outcome, taking a full medical
history, and discussing the pros and cons of each operative procedure would not
be in your best interest. I would suggest that your plastic surgeon be
certified by the American Board of Plastic Surgery and ideally a member of the
American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are
comfortable with. You should discuss your concerns with that surgeon in person.
Robert Singer, MD FACS
La Jolla, California
I am 118lbs and 5'6 tall. I am currently a 32A cup barely. I want to get a BA, but what size should i get?
Seek out board certified plastic surgeons with good before and after pictures in your area and go in for a consultation. At your consultation, the surgeon can discuss implant types and sizes that will best fit your frame and achieve your size goals. Most surgeons have different methods for helping you determine size-some use 3-D imaging, others uses sizers placed in a bra. Both methods seem to work equally well.
Thank you for your question. It is not uncommon to be unsure what size to aim for with a breast augmentation. Rather than focusing on a bra size, we recommend having a "look" in mind. For that reason, we have a sizing system in the office that allows you to see how you would look with different volume implants. The system allows the patient and surgeon to better understand one another when discussing the desired goals and how to best accomplish those goals. I think it is best for the patient to know what size and type implant they will be getting during their surgery rather than be surprised after surgery. I often hear of patients being unhappy because they were not given the size they had in mind. I suggest you consult with one or more board certified plastic surgeons certified by the American Board of Plastic Surgery to further discuss your options. I hope this helps. Best wishes!
I want to get a BA, but what size should i get?
Thank you for your question. This is an excellent question and one of the most common one I hear in the office. The appropriate size for any patient is a combination of the patient's body size and shape, the desired look, the skin and breast tissue that needs to be filled. I have found that the appropriate size is best determined through a collaborative approach between the plastic surgeon and the patient. The plastic surgeon must assure that the implant "fits" the patient's body and to do this he/she will take several measurements, including the factors such as how much breast tissue and skin laxity is present. The patient will often trial various size implants in a loose fitting bra such as a sports bra. Most surgeons will have a spectrum of implant sizes in the office to trial. I also highly recommend patients do trials at home using the "rice test". See the web reference below for more information. This allows them time to relax and try many different sizes, try at more than one session, and obtain the input from family and friends as needed. Once the patient has an idea of the size (really volume) of the implant they desire, the surgeon can find the correct implant in that size that fits the chest wall and overall body features. One note, beware of trying to predict your post operative cup size. There is no reliable way to predict cup size based on implant size. I hope this helps. BRK