I'm trying to decide between 475cc and 525cc and mod + or HP. What is your opinion? (photos)

Question

I have found my ps & decided on round silicone implants and I tried on 475cc & really liked them but my max would be 525cc. I have been told by several people to go as big as I can. I am currently a 34B, not completely filling out a B cup. I am 5'6" 140 lbs. I want them to look proportional to my body and I would like cleavage with no bra. First pic is me and second is my "wish" pic. Thank you!!

Mathew C. Mosher, MD · Answer

There is very little difference between the two devices that you are considering. A HP implant will produce a more rounded final result and would appear to better fit your frame and base width. However, in both cases you appear to be choosing implants that have larger dimensions than your tissues would be most suited to. When decisions are made solely on the basis of "wish pictures", and not on your tissue and anatomical assessment, the complication and revisional surgery rate widely published for primary augmentation is approximately 20% in the first 3 years. If you turn out to be the 1 out of 5 patients who needs repeat surgery in the first 3 years, you should be prepared for this. Furthermore, the wish pic you are desiring is labelled as a 4 month post operative outcome. I understand that this looks very nice to you. Understand that over the longer term, sagging, ripples, tissue thinning, loss of upper pole cleavage and implant malposition of one or both devices is a high probability with larger devices. More proportional implant choices may not achieve your ideal after photo look, but may be wiser  and associated with a lower complication rate. As an informed consumer you will be solely responsible for future surgeries.

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

Tom J. Pousti, MD · Answer

Thank you for the question.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. Ultimately, careful selection of plastic surgeon and  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, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
Given your concerns, it is definitely worth spending more time (preferably prior to the date of surgery) with your plastic surgeon to discuss further.  One question that might be helpful to you: will you be more disappointed if you are slightly too small or slightly too big?My advice to you differs from what you have heard from "many people": not necessarily shoot for as "big as possible".  I suggest you go only as big as necessary to achieve your desired look.
 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 “proportional” or C or 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 for an outcome that you will be very pleased with.

Robert D. Wilcox, MD · Answer

Dear Ecwh.1722,
  
 
  
First of all, because of your small stature and size of your torso, you should stay with a high profile, but understand that your friend’s well meaning advice to go as large as you can is frankly bad advice.  When you go as large as you are on a frame as thin as you are, you are at much higher risk of nipple numbness and a dreaded complication of bottoming out, which means the implant starts to slide down the torso and requires surgical revision.  When we see this, it is almost always in thin women, such as yourself, or patients who are post bariatric surgery.  Also, you certainly will not look as natural as the model you have projected on the right as she clearly has more tissue to start with as you can see by the amount of subcutaneous fat that she has above and below the breasts.  In short, if you go with the sizes you are suggesting, it will look very unnatural and you will be at increased chance of complications.  I hope that this has been helpful.

Jon E. Rast, MD · Answer

Based on your pictures it appears both implants that you have selected will be very large for your body.  You are thin with not a lot of breast tissue for coverage of the implant.  Also, you may not achieve cleavage like your goal picture.  You should base implant selection on your tissue measurements.   Best of luck.

I'm trying to decide between 475cc and 525cc and mod + or HP. What is your opinion? (photos)

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I'm trying to decide between 475cc and 525cc and mod + or HP. What is your opinion? (photos)

Answers (6)

Answer: Implant Answers

Answer: Implant Answers

Answer: Implant selection

Answer: Implant selection

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Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.