Doctor Answers 8
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
Be careful with large implants
Thank you for your question. Making a decision regarding implant selection requires a personal assessment and physical exam. A large portion of the decision making will come from your goals and the surgeon's comfort/style. A larger portion is actually determined by your body type. This is comprised of the measurements you've provided here but also your skin/breast tissue characteristics. Your body will only tolerate up to a certain size before bad things begin to happen. These bad things could include wound healing difficulty, thinning and stretching of the breast tissue/skin, migration of the implant out to the sides (into your armpit) or down (onto your upper abdomen), to name a few. You should always try to pick the smallest implant that will safely meet your and your plastic surgeon's expectations.
Personally, I think that's going to look crazy!
It's impossible to say if that is even a good idea without a photo, but that is a huge implant for a 34A! Most women with an implant that size worked their way up to that -- they didn't do it all at once. You're putting yourself at risk for a whole bunch of problems down the road if you go too big. Just trying to help!
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34A - 650cc breast implants
650cc implants are very large for someone with your dimensions or for anyone else for that matter. Please keep in mind that your surgeon will need to cut/dissect more tissue to make room for them to fit. Once this is done - the entire area is weakened. Placing heavy implants in a pocket solely supported by skin does not provide ample support. You run the risk of your implants descending down your chest stretching skin and surrounding tissues. This is not a good look. Your best option is to choose a smaller implant that will not cause as much damage to your tissues in the long run. Please look at the forum on this site on breast augmentation revision. Do your homework before making a final decision.
Best wishes and kind regards,
Hello and thank you for your question. The size of the implant is based on your desired
breast size/shape, your chest wall measurements, and soft tissue
quality. This decision should be based on a detailed discussion
with equal input from both you and your surgeon. This entire surgery can be performed with a
small incision technique. Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results. The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
Best breast implant size?
The interpretation of "natural looking" varies greatly from patient to patient and from surgeon to surgeon.
The best cosmetic result in any particular breast
augmentation patient depends on a variety of factors, including: Your
individual anatomy, desired outcome, 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
There are no manufacturers' standards for cup sizing in the bra industry. The cups of a 34 D-DD+ and a 38 D-DD+ are significantly different. Cup size varies from manufacturer to manufacturer and even within styles from any particular manufacturer. There is also no direct correlation between an implant size or shape and resultant cup size.
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 that your plastic surgeon be 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
Best breast implants for me?
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. You will find that there is no accurate/reliable/predictable correlation between size/profile breast implant utilized and cup size achieved.
***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 "C or D cup” to "look OK" 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.
Hello and thank you for question. I typically don't talk about size too much with my patients and I explain to them that there is no exact science in determining what the final size of someone will be after breast augmentation. The final size depends on many different factors. However if I was to estimate I would say you would end up somewhere around a DDD. Maybe 1cup size less maybe 1 cup size more. To know whether this would look "ok" would require an in person consultation during which I could assess your tissue, breast size and shape and take measurements. Most importantly however, I would need to determine what your goals and expectations are after augmentation. I can only go by the information you have provided, but I can tell you that a 650cc SRX is wider than the breast base width you have relayed. Hopefully you are being evaluated by a board certified plastic surgeon and he has discussed the pros and cons of choosing this sized implant. In the end only you can decide what YOU think will look ok. I hope this helps and wish you the best of luck!
Ankur Mehta MD