Mixed feelings about implant size. 475cc or 495cc. BWD: 13cm wide, 4"11, 150 pounds. (Photo)

It seems that you are making a great choice with the 475-495cc implant size range.Various methods important to discuss with your surgeon
include:1.Goal photographs to demonstrate potential size
and shape. This gives your surgeon an idea of “the look” you are going after.2.Trying on sizers in the office. Sizer will give
a physical/PALPABLE demonstration of how the implants will change the volume of
your breasts. See yourself in a full size mirror while trying on these sizers.
We have tight fitting t-shirts to wear over the sizers to show how you will
look with the implants.3.Using 3D imaging (offered in my office) to
provide a VISUAL demonstration of how the implants will change your breasts and
the look that you will likely achieve. The software is super cool (CRISALIX)
and actually allows me to select the implant manufacturer and size.

Be open with your surgeon and it never hurts to go back a
second time with a loved one to confirm the implant size before surgery.

I hope this helps.-Dr. Bryson Richards (Las Vegas Plastic Surgeon)

Hi BA,There isn't much difference between these two sizes, so I wouldn't fret too much, and your PS is ordering both!  That's nice.  Without examining you I can only give you some general suggestions.  First and foremost the implant should fit the dimensions
of your breast and tissue cover. But you already have this figured out!  WTG.  As you can see from what I say below, you are going pretty big.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. 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". 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 50 cc (1-2 oz.) 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 about 25-50 cc, 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. Then, the patient’s verbal requests
are factored into the analysis.Our
average size over the last 7,000 implants was 350. 90%
of our patients wish they were bigger a year after BA.I t is like your mind
incorporates the "new you" into it's self-image over a period of
time. 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 (Flash) Recovery Breast
Augmentation articles from peer-reviewed surgery journals.All the
best, “Dr. Joe”

It sounds like you are on the right track you have selected a board certified plastic surgeon and are doing some good research on implant size and shape.  According to your goal photos and your preop photo the implant selected seems reasonable.  If you still have questions I recommend you talk with your PS again before surgery, and consider getting a second opinion if everything is not clear.Best of luck,  

Thank you for your question and photographs.  Based on your goal photographs, I would recommend the larger of the two sizes, though 20cc's is not a lot of volume difference (less than an ounce), it looks like you would prefer to be on the larger side.

please don't overthink this.  the difference between 475 and 495 is less than a shot glass.  when in doubt go for the bigger one

If there is a complaint about size after breast augmentation it's almost always that the patient wishes she'd gone somewhat bigger. Remember that there are good sizing systems that you can use to try out different implants to help with the decision process prior to the operation.

There are many variables in recommending implant size/type. I base my implant recommendation on patients' body (chest height, chest width, existing breast tissue) as well as their desired look. I would go for the desired look. Review before and after photos and see what kind of look that you want. Share your wish photos with your plastic surgeon.Implants come in different types (silicone, saline), shape (round, anatomic), and profiles and volume. More meaningful recommendation can be made based on direct examination and in-person consultation. Please visit with a board-certified plastic surgeon.Best regards.

Thank you for your question. There is very little difference between the implant sizes you have mentioned in the size range you're considering.  I would most likely recommend going with the larger of the two so that you don't have size regret after the procedure. You may want to have another consultation with your plastic surgeon and preferably undergo Vectra 3-D imaging and simulation of your results.  Breast of luck. 

From your photo and your "goal" pictures, you will likely end up disappointed. You need a lift and a larger implant (whether 475 or 495 - which is virtually identical) will only make you sag more. The breasts are already on your upper chest and your nipples low. Intraoperative sizing is a good idea, but so is the proper operation. Go see another surgeon or make your surgeon show you before and after photos where he can achieve the results you want without a lift. You should see a board certified plastic surgeon in your area to get a formal opinion through an in-person consultation.Best of luck,
Vincent Marin, MDSan Diego Plastic Surgeon

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, and computer imaging) will be critical. Keep in mind, that breast augmentation surgery does not provide a true "lift"; make sure that your goals will be realistically achieved with the planned procedure.

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” or "too small" 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. Personally, I find it most beneficial to have a wide range of breast implant types, sizes, and profiles available.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.