I'm a 36C and want full C or small D. Not sure on the size of silicone implants

Question

After 3 kids and 3 breastfeeding I am planned for a mastoplexy and BA in 2 weeks. However not sure on the size of Silicon implants to get full C or small D. Im 36 yo, 124 pounds and 5'4", all standard sized, athletic. My breast are 14 cm wide. Thanks!

Joe Gryskiewicz, MD, FACS · Answer

Dear Marie,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".  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.  See video below.All the best, “Dr. Joe”

Jose M. Soler-Baillo, MD, MS · Answer

Thank you for your question.  Unfortunately without photos and more importantly, an in-person evaluation, it is nearly impossible to tell you what would be best for you.  Please be sure that you are seen in person by a board-certified plastic surgeon to determine what would be both best and realistic for you.  Also, keep in mind that it is nearly impossible to predict cup size prior to surgery.All the best,Dr. ResultsMiami, FL

Emmanuel Mallol Cotes, MD · Answer

Thanks for the question.First of all I recommend you to send your photos to us to give you better advices and recommendations of your interest. In my practice I recommend silicone implants, 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.Respectfully, Dr. Emmanuel Mallol.-

Tania Medina de Garcia, MD · Answer

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. I would recommend you to get a consultation with a board certified plastic surgeon to check about the difference between implants and cup sizes, hugs!

Tom J. Pousti, MD · Answer

Thank you for the question. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.Given that your surgery is coming up soon and you have ongoing questions/concerns, I would suggest that you spend more time communicating questions/concerns directly with your plastic surgeon, 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.

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. For example, 
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, the use of computer imaging has been very helpful during the communication process, in our practice.

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, after the use of temporary intraoperative sizers.I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes.

Nicholas Tarola, MD · Answer

Thank you for your question.  We always tell our patients that we are not necessarily aiming for a definite postoperative bra cup size, rather a size and shape based on other before and after photos as well as the appearance during sizing in the office.  The reason for this recommendation is that every bra manufacturer sizes their bras slightly, or significantly, different than another.  If you have not already used a sizing system (not just regular implants) in your surgeon's office, I recommend doing so before your procedure so you can see what different volumes will do for you.

Marc J. Salzman, MD, FACS (retired) · Answer

In my practice, we use dimensional planning based on your base width of your chest wall, and using computer imaging in three-dimensional photography, can  can best predict which size will look good on what body frame. Having said that, when adding a breast lift into the picture, it's been my experience that smaller implants and more skin removal leads to a more durable result in lifting a very small amount over a very large implant. Try to find a board-certified plastic surgeon in your region with experience in this combination surgery. Good luck.

M. Dean Vistnes, MD - Account Suspended · Answer

Your best bet when you are trying to decide on implants is to try on sizers of the exact implant you are considering inside a very tight sports bra. This will give you a close idea of what you will look like. More importantly the dimensions or width of the implants need to match and fit your frame and body. If you are working with a board certified plastic surgeon with an expertise in breast augmentation he or she should be able to help you with this in their office. Good luck! Dean Vistnes, M.D.Vistnes Plastic SurgerySan Francisco Bay Area#drdeanvistnes #breastaugmentation #realself #breastlift

I'm a 36C and want full C or small D. Not sure on the size of silicone implants

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