Is 385cc HP a good size for my goal?

Question

I’m very petite 5’1 and 100lbs. My BWD is 12. Starting with 32B. Since I’m so petite I really could only choose between UHP and HP. My end goal is a natural yet fuller top and perky breast and more cleavage. As you can see in my pre op photos I have relatively decent breast tissue. Would 385cc HP help me reach my aesthetic goals and get me to a full C/D cup? Or should I upsize/downsize?

Caner Kacmaz, MD · Answer

Breast implants are sized according to their volume in cubic centimeters (cc).

How do you know what size implant to choose? Looking at pictures and talking to friends who had a breast augmentation might help.

Off course the volume will depend on the shape and size of your actual breasts, your frame and the size you want to achieve.

Our plastic surgeon will advise you thoroughly. Bringing pictures of a desired restult to be shown to our surgeon, might be very helpful.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person evaluation by a plastic surgeon to be measured and discuss your goals. 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 profile 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 is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Gary M. Horndeski, MD · Answer

Your goal is a natural fuller top and perky breast. You will never be able to achieve this with implants alone and certainly not with 385 cc implants. 385 cc implants will take you to size F. The technique I recommend is a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired. Implants are not lifetime devices. 8% fail within the first year and 30% fail within six years. Fat transfers are permanent and incorporated into the body.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

John L. Burns Jr., MD · Answer

I suggest doing 3D breast imaging so you can see exactly what you would look like with different implant volumes or profiles.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph. Based on your starting point - which shows a lot of natural breast tissue that already resembles an augmentation with implants - 385cc would likely get you to a DD or larger. I would recommend trying on sizers in your surgeons office so that you can get a better visual representation of what implants that large would look like.  Best wishes.

Ram Kalus, MD, FACS · Answer

As you undoubtedly know, a precise treatment plan or specific implant size recommendation can only be determined with a careful examination and detailed discussion with your plastic surgeon. Volume (385 versus any other), is far less significant than implant width and projection. As you already suggested in your question, implant width is indeed important, and can be thought of similar to shoe size. The implant literally needs to fit into your breast and chest. A 385 HP may well “fit” your breast, but the volume and projection are what will determine the “look” you want, similar to the style or type of shoe you would select. It is true that for a given volume a high profile implant will have a narrower diameter, and it is also true that a person such as you with a petite frame will require a narrower diameter implant than a patient with a broader chest or larger frame.  Other considerations such as saline versus silicone are also important, as are "round" versus "anatomical" or "form stable" or "shaped", smooth surface versus textured, and softer versus firmer with the different levels of gel cohesivity.

The term “natural” can mean different things to different people and the profile of the implant does not necessarily determine that. You can certainly achieve a “natural” appearing result with a high profile implant if properly selected, but as a rule, the larger the implant and the higher the profile, and certainly if the implant is positioned too high, the greater the chances you will look “augmented” because of exaggerated upper pole fullness or convexity.

In my practice, besides a thorough interview process and physical examination with careful measurements, we use on lay sizers within an unpadded bra to help you understand what you are likely to look like in a bra, bathing suit, or T-shirt with a given size implant. In addition, and this is critical, we ask all of our patients to provide us with photos of their desired final look, with images of women’s breasts that most closely resemble the look they are trying to achieve. This serves as a visual guide that thankfully rarely leads us astray. The most common reason for patient disappointment after breast augmentation is size-too big or not big enough. This algorithm which we have been employing for over thirty years has proven to be very successful.

Because all of these factors can leave you quite confused, it is crucial that you select an experienced board certified plastic surgeon whose aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion if necessary to be sure and feel confident about moving forward with scheduling surgery. Make sure that you share with your plastic surgeon photographs of your "favorites" or ideal. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

Daniel Barrett, MD · Answer

Dear 2021tatas,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

Kenneth Hughes, MD · Answer

None of the modalities to approximate final results from breast implants are 100% accurate; they merely facilitate the patient and the board certified PS concurring on the size and type of breast implant which will come the closest (in your case, 385 cc) to reaching the patient's goal.
My patients prefer to try on implant sizers under garments they typically wear (workout tops, bikini, tight sweater, low cut dress) to determine if they fit as expected and help allay some of their trepidation associated with this decision. I would recommend that you go with the size that boosts your self-esteem, and fits your anatomy. It's unlikely that you will notice a difference in increments less than 100. Breast IMPLANT size has nothing to do with BRA cup size - which varies with each bra manufacturer. The average implant volume placed in the US is 350cc. A very general estimate is that one cup size is 150 to 200 cc of volume, but realize that no direct correlation exists between the two.

Ali Gurlek, MD · Answer

Thank you for your photos.
If you're considering breast augmentation, talk to a plastic surgeon. Make sure you understand what surgery involves, including possible risks, complications and follow-up care.

Connie Hiers, MD, FACS · Answer

With the size implant you are considering and the amount of breast tissue you have, you will wind up with large breasts that will be too large for your frame. I would suggest going smaller and staying more proportional.  Otherwise, when you are older, you will find yourself going down in size and needing a lift.