Is 275 cc silicone big enough? Should I get inverted nipple correction with the implant or no?

Question

i am a petite person who is 5'3 & 112 lb. I had hoped to achieve a moderate to full C cup size. My PS recommended 275cc (maybe max of 300cc) silicone under the muscle through incision under the boob which will give me a full B to small C. I felt like this is too small & would not get the look i want. I thought since i have no breast tissue to begin with, i would need at least a 350cc. He also does not recommend inverted nipple correction with the implants since the stitch can pop, but i want to

Donald R. Revis Jr, MD · Answer

Good afternoon,
I would absolutely correct your inverted nipples at the same time as your augmentation- there is no reason to do two surgeries- maybe your surgeon needs to review the textbook on inverted nipple correction so his sutures don't break! I would determine the size of your implants by measuring your chest, reviewing photos with you, and having you try on the implant sizers here in the office. Given your appearance and description, I would definitely look in the 350cc range!

Leland Deane, MD, FACS · Answer

I would tend to agree with your surgeon. An implant above the size he recommends will probably increase the chances that you will bottom out, have displacement of the implant, visible implant borders, asymmetry, even rib depression, etc etc. There's a lot that goes into determining implant size, and you should know that most of the complications occur, IMHO, because of implants which are too large.
Next, the ductal tissue around the areola is considered 'dirty' to the extent that there are bacteria in the ducts and parenchyma. The current theories about capsular contracture center around bacteria causing increased risk for capsular formation. Some surgeons even cover the nipples during breast augmentation surgery. Therefore cutting into the base of the nipple during your augmentation surgery seems risky.

Michelle Zweifler, MD · Answer

In general 300cc increases bra size approximately 2 cups. Often implant size is determined by patient desires, patient breast width and skin quality. Sizers in the office are used frequently to help decide.

Nipple inversion should be delays as a second procedure under local anesthesia to minimize any implant risk of infection.

Nipple inversion should be delays as a second procedure under local anesthesia to minimize any implant risk of infection.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Inverted nipple correction recommendations vary from surgeon to surgeon- I don't. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs. Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend seeing additional board certified plastic surgeons to ensure that the implants you decide upon are the right ones to meet your expectations. You may wish to "try on" several of the implants so that you can have a better visual representation as to what they would look like. As for an inverted nipple correction, that could be safely performed at the same time. Best wishes!

Salih Onur Basat, MD, EBOPRAS · Answer

Hi and thanks for your question. You are a good candidate for breast implant. I recommend round implant with dual plane technique for you. Round implant can give a more natural result with upper pole fullness for your case. You have not enough breast tissue, because of this I recommend dual plane technique for you. In this technique upper part of implant is covered by chest muscle and breast tissue, lower part of the implant is covered by breast tissue. I recommend around 400 cc implant for your case.With this combination you can get good result. This operation takes 1.5 hours and can be done under the general anesthesia. You should stay one night at the hospital to get rid of the anesthetic drugs affect. After surgery you should use sports bra and breast band for 6 weeks. Two weeks after the surgery you can start sports but you should wait for 6 weeks to use your arm strongly. I don’t recommend inverted nipple correction surgery at the same time. You can get this treatment after breast feeding.
Best of lucks.

Daniel Barrett, MD · Answer

Dear Persistent360188,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, 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 it is 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, every one of them has 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.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Robert M. Tornambe, MD · Answer

I appreciate your concerns but please don’t get too caught up in numbers when it comes to choosing an implant that is right for you. I appreciate your desire to be as large as possible, however you must consider the fact that you are somewhat petite, and extremely large implants may not suit your body type. While 350 mL implants may be an option, smaller implants with higher profile, like moderate plus or even high profile may provide similar results without the extra size.
Also, I commonly correct inverted nipples at the same time as breast augmentation with successful,  lasting results.
 I try to tailor each breast augmentation operation to my patient's desires and body type.    I ask my patients to bring in photos of breasts the size they desire, because there can otherwise be confusion because B or C cup can vary greatly by brassiere manufactures! I also utilize the implant in the bra technique, with several different implant sizes with a tighter fitting T-shirt to get an idea of what you will look like. Be sure to consult with a board certified plastic surgeon and go to your consult with all your questions written down so you don't forget to ask something. Good luck!

Camille Cash, MD · Answer

From the photos it appears you are a good candidate for breast augmentation.  An exam with your breast measurements would be needed to give specific advice, but it appears you may be able to go larger than 275cc.  It makes sense for you to have your inverted nipples corrected at the same time as your breast augmentation instead of undergoing two separate procedures.

Garrett A. Wirth, MD, MS, FACS · Answer

That size should be nice for you although I don't have your breast measurements.  You might be able to tolerate a larger volume depending on your tissues.  Keep discussing with your Board Certified Plastic Surgeon to make sure you are working as a team.  I would not recommend doing the nipple correction at the same time.  While it may work out fine, there are some increased risks. Best wishes.