Is 550cc too big for me?

Question

I am 21yrs old, weigh about 135lbs, 5'4 and 34B. My doctor initially suggested 475cc, I chose to go up a size to 520cc's. Now that I have taken sometime to think about it, I am contemplating going up one size more to the 540-550cc range. I respect my plastic surgeons thoughts and think he is the best in the area.. but I don't want to regret not going big enough. I am hoping to go decently larger and also like the "fake" look. We decided on "gummy bear" and sub-muscular.

Daniel Barrett, MD · Answer

Dear cgarcia0205,determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. 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 its 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, everyone of them have 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.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery 
Member, Am. Society of Plastic Surgery

John Diaz, MD · Answer

It is very difficult without assessing you in person to know if the implant size and profile you mentioned will be a good size for you. Keep in mind that implant size selection not only depends on your personal preference, but it also depends on your unique measurements. There are various types of implants that can help you attain the look you are going for. A thorough consultation with a board certified plastic surgeon will allow you to communicate what your desired result is and will inform you as to what is possible to achieve your goals. We have a device called the Vectra 3D imaging system that shows you what you will look like with any implant. Our patients are very happy with the choice of implant they make when using this system. To learn more about breast augmentation, you can read “A Comprehensive Guide to Breast Augmentation.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.
  
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.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  
  
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 liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.
  
Anatomic gummy bear implants might be a good choice to give you volume.
  
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.
  
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.
  
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. Schwartz
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

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.  550cc is a large implant.   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.   
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the best size you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implant

Richard Baxter, MD · Answer

Your individual measurements especially base diameter of the breasts determine which implants your body can accommodate. Also keep in mind that larger implants = larger potential problems. It is worth spending some time with your plastic surgeon to make sure that you are on the same page in terms of balancing what you want vs what fits your body's individual anatomy.

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

Jon A. Perlman, MD (retired) · Answer

No one can advise you without the opportunity to examine you and judge the volume capacity that your breasts can accept.  I choose to select the final implant volume at the time of surgery when sizers or test implants can be placed and the actual outcome determined.
I would also tell you that in general a 550 cc implant sounds very large for a woman beginning as a 34 B cup.  You may need to reconsider this and allow your surgeon to make the best implant selection for you at the time of the procedure.  Please watch the attached video about the downsides of having very large implants over many  years.  
Best wishes for a good result.
Jon A Perlman MD FACS 
  
Certified, American Board of Plastic Surgery 
  
Member, ASAPS, ASPS
  
Extreme Makeover Surgeon, ABC TV 
  
Best of Los Angeles Award 2015, 2016 
  
Beverly Hills, Ca

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