Dual plane method, will my implants look smaller than the sizers?

Question

I’ve been recommended 330cc sebbin high profile micro-textured implants using a dual plane method. I’ve seen patients saying when the implant is placed under the muscle it looks smaller than what the sizers do. As this is an in-between method, will the sizers be accurate? I’m 5’7 and weigh around 117 pounds so I’m tall and skinny. Im worried 330cc will end up looking smaller than I’m anticipating! Also, I’m finding it hard to visualise real results! Help.

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well;..based in your question its difficulted evaulate your case if the question dont have a picture, its recommended to get a consultation in personal with a plastic surgeon.

Tom J. Pousti, MD · Answer

Although useful as rough guidelines and as communication tools, all the modalities currently used to predict what breast implant size/profile will best achieve a patient's goals with breast augmentation are NOT very accurate, in my opinion. The use of the rice test, sizers placed beneath a patient's bra, goal pictures, computer imaging technology… are all useful, but not necessarily as accurate as one would hope.
In my opinion, nothing will replace careful verbal preoperative communication with your plastic surgeon, preferably in front of a full-length mirror along with the use of as many "communication" tools” listed above.In my opinion, it is not possible to accurately determine how many ccs (if any) a patient would “lose” when undergoing sub muscular breast augmentation surgery. I suggest patients do not make decisions based on statement such as: “you will lose 25 or 50 cc of volume when breast implants are placed under the muscle”. These statements are simply not reliable enough to utilize clinically. 
***Given that your surgery is coming up soon (and your ongoing concerns), I would suggest that you schedule additional time to spend with your plastic surgeon communicating your goals, preferably prior to the date of surgery.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.
I hope this helps. Best wishes.

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.  The implant will not decrease in size when placed in a dual plane.  If you are concerned about 330cc not being large enough for you, then you may want to consider increasing the size slightly.  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.   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.   
 
 Best wishes and good luck.

Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon

Robert L. Kraft, MD, FACS · Answer

I agree that you should not consider textured implants until the FDA has reached a definitive conclusion as to their safety.  Implants do appear slightly smaller when under the muscle so it is reasonable to increase the sizing by 10% to account for this. Best wishes.

William B. Rosenblatt, MD · Answer

I no longer use any textured implants as they seem to be the only ones related to the new problems of ALCL. I would either get a second opinion or find out why you need textured implants for a purely cosmetic operation.

Dual plane method, will my implants look smaller than the sizers?

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Dual plane method, will my implants look smaller than the sizers?

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Answer: Breast implants

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