I'm struggling with the sizing and am stuck between 450cc and 485cc and my surgeon has suggested Allergan Natrelle Inspira TSFs.

Question

I am 5ft10" weight is 142lbs, rib cage under breast measurs 31.5". Current size is 36c but want to go to about 34/36 e/f. I want to wear dresses without a bra with a low scopping neckline & a cleavage without the push up bra occassionally. I started at a 520cc, came down to 485cc as more comfortable for exercise, but now feeling that 450cc is more manageable size, although it depends whether the implant fills up top tissue or sits over the breast as people tell me differently!! very confused.

Larry Weinstein, MD · Answer

the difference you are contemplating is small. I would go with the 450cc vs the larger one based on long term tissue considerations. However the width of the implant may be more important to you for your final look to get a full or lesser cleavage.

Larry S. Nichter, MD, MS, FACS · Answer

Choosing the best sized and shape implant is confusing at best. By the way you are struggling with the difference of about a single shot glass - pretty small difference. Here is my best advice to you and what I recommend to patients: It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below

James N. Romanelli, MD, FACS · Answer

Your best bet is to use sizers, and 3D imaging in order to try to "preview" your result.  It will be very difficult to see a difference of 35ccs.  Best of luck!

Josh Olson, MD · Answer

There is very little difference between 450 and 485cc. Use sizers and add 30-50cc to achieve the look you like with the sizer. Bigger isn't always better. Discuss your goals with your surgeon as nobody online can understand your ultimate wishes without a lengthy conversation and using photos of breasts you hope to have. Good luck!

Gary Lawton, MD, FACS · Answer

You should try on sizers to get a good estimate of what the volumes will look like on you.  None of these volumes will make you an E/F.

Arnold S. Breitbart, MD, FACS · Answer

An important consideration as to what size implant is used, is what cup size you ultimately want to be.  There is not much difference between a 450cc and 485cc implant.  During the surgery, your surgeon can use sizing implants to see what size looks best with regards to what cup size you want to be, and then select the best implant size.

Robert Singer, MD · Answer

There is minimal difference between the 2 sizes.The best
cosmetic result in any particular breast augmentation patient depends on a
variety of factors, including: Your individual anatomy, realistic expectations,
a thorough discussion with the plastic surgeon about the options, and an
understanding of the pros and cons of any particular implant choice. Proper
sizing is not just about the number of cc’s. The thickness of your tissue,
breast dimensions which include the width,
height, and projection, as well as chest wall width all need to be considered
when choosing an implant. Trying on implant “sizers” of various shapes and
volumes while wearing a tight t-shirt, bra, or bathing sit at a preoperative
visit will help you and your surgeon choose the optimal implant.

There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 36 E/F and a 40 E/F are significantly different. Cup size varies from
manufacturer to manufacturer and even within styles from any particular
manufacturer.

Keep in mind that following the advice from a surgeon on this or any other
website who proposes to tell you exactly what to do without examining you,
physically feeling the tissue, assessing your desired outcome, taking a full
medical history, and discussing the pros and cons of each operative procedure
would not be in your best interest. I would suggest you find a plastic surgeon
certified by the American Board of Plastic Surgery and ideally a member of the
American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are
comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Steven Wallach, MD · Answer

A small volume difference between implants usually does not create a large difference. Talk to your surgeon o "nail down" a final size.

Mark D. Wigod, MD · Answer

Sometimes, patients get stuck between two or three relatively close sizes.  I advise not to worry too much because the volume differences are usually only 5 to 10% which is difficult for even a practiced observer to notice.  Then, I ask what are you more afraid of, being too large or too small?  Whatever you are most afraid of, size in the opposite direction.

Sanjiv Kayastha, MD · Answer

As you have discovered choosing a breast implant can be a complex process. Without a thorough interview and exam no useful advice can be offered. Find a plastic surgeon you trust and review your goals with them. I typically have patients try on sizers and bring in pictures that show the result they are looking for. Your surgeon should be able to help guide you regarding this choice.

I'm struggling with the sizing and am stuck between 450cc and 485cc and my surgeon has suggested Allergan Natrelle Inspira TSFs.

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