Have I choose the right size?
Doctor Answers 7
Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery
I appreciate your question.
The size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve. If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.
Silicone will give you a fullness at the top (upper pole fullness).
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.
Anatomic gummy bear implants might be a good choice to give you volume.
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.
The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
Best of luck!
Board Certified Plastic Surgeon
The Best Size
It's difficult to advise accurately without seeing you in person but I would tend to think the 300 and 350 cc implants will be too small. Especially if you are already concerned about that. Realize that your surgeon can never guarantee a cup size because there's no standard in the bra industry but in my practice I tend to picture about 200 cc per cup size. If you are an A cup and B cup now then at minimum I'd suggest the high profile implants with at least 385 to 400 cc. Generally I anticipate 300 or 350 cc to only increase a woman's cup size by about 1.5 cups. Talk to your surgeon about your concerns and best wishes!
What size implants
This is a common question asked not only in forums, but also in the offices of cosmetic plastic surgeons. It seems to be a source of some angst for most women as they have tremendous concern for what the final outcome might be. I find that several things over the last 25 years have helped patients decide which type, shape, and projection ratios will best suit their needs. I think it's helpful if the patient brings in several photographs of what the goal look of her breasts might be. Also, if she can bring some photographs of what she doesn't want, this will eliminate trying to express in words what “natural”, “high cleavage”, “low cleavage”, “fake”, and “stripper” may mean to her. I have likewise found the Vectra 3-D imaging platform to be the single most helpful tool in trying to visualize what the outcome might be with different sizes as well as shapes of implants. The Mentor shell sizing system, in which a shell of implant material is placed over the breast and in a padless bra, can likewise be helpful in that it can, not only show the size in a bra, but can give the patient some idea as to what the weight of the implant might be. In my opinion, the implants will look best when the base width of the implant is at, or just slightly less, than a natural base width of her breast. Considerations of chest wall abnormalities, location of breast creases, shapes of the breast, amount of overlying breast tissue, stretch ability of the skin and breast over the implant, among other things also play a role in trying to decide which implant will look best on each individual patient. It can also be helpful if the plastic surgeon, during their consultation, can provide some insight into what the likely outcome would be with different sized implants given their experience in breast implant surgery over many years. We ask our patients to bring different types of clothing such as evening gowns and bathing suits as well as a tight shirt to evaluate what the implant might look like under these type of clothing options. It is also possible to make a home made breast sizer using grain rice. Approximately 1 ounce of rice equals 30 mL of breast implants volume. The rice can be placed into a pantyhose leg and enough volume left in the pantyhose such that the rice can be flattened out. You can then tie off the pantyhose and cut off the excess. This flattened rice volume pantyhose can be added on top of the breast inside of a padless bra and can give a rough approximation of what the corresponding implant might look like. Besides the size, most plastic surgical consultations for breast augmentation will also deal with the shape of implants, whether round or anatomically shaped. Here I think the Vectra really shines in that you can place two images next to each other, one with the shaped implant and one with a round implant such that the potential breast implant patient can really see what the difference would look like on them. All things considered, this can be a fun process and the vast majority of patients in my practice are quite happy with their end result. Hope your surgery goes well and good luck.
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The right size for you
It is very difficult to determine the best lift you will need (recommended based on your photos) or 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 300 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. The same process goes for just filling in the upper part of your breast without becoming much larger. 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 including silicone vs saline implants
Choosing the best implant size
Thanks for your question. Choosing the correct implant size is a huge part of your experience with breast augmentation. So much of the process is individualized that it would be nearly impossible for me to give you the kind of information that you would want to use for your decision making over the internet. Instead, I would encourage you to seek out a practice that has advanced tools to help with the process, things like the VECTRA 3-D imaging system that lets you see about what you will look like with different sizes and styles of implants. It has absolutely changed the process and the success rate for choosing the best size implant in our practice.
Have I choose the right size breast implant?
You should definitely revisit your plastic surgeon and try on breast implant sizers to see if the chosen volumes seem large enough to you. You can also do the Rice test at home to help you in choosing a size. The Rice test is described in the article in the link below:
Have I chosen the right breast implant size?
Thank you for the question. Online consultants will not be able to provide you with specific enough advice to be truly helpful. 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.
***Given your concerns, I would suggest that you schedule additional time to spend with your plastic surgeon communicating your goals, 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 "smaller than a 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.