Breast augmentation. Difficulty choosing cc's. Don't want them too large for my frame! (Photo)

Hi Candace,Either one would be fine for you in my opinion.........you are petite and this is a fairly average amount.  Here are a few tips for you because this is perhaps
the hardest decision for a patient to make, as well as the surgeon. Also see the video attached to my answer. We spend up to two hours for our BA consults
to be sure there is careful communication. We do a full exam in front of a
full-length mirror taking six exact measurements.We
put your photos on a large computer screen for imaging, and go over your
“ideal-size” photos. We then save this information to your password protected
“web account.” First and
foremost the implant should fit the dimensions of your breast and tissue cover.
Balancing the implant to your
over-all body shape and tissue cover is essential.The main thing is to
have the diameter of the implant fit the diameter of your breast "foot-print".
Higher profile implants tend to have a smaller diameter.Higher is really a marketing term, but often
translates into the same volume implant with a narrower base.Saline implants actually tend to decrease in
diameter as they are inflated!The average size chosen over our last 7,000 breast implants was
“350cc”.BUT, 90% of our patients tell us they wish they were
bigger a year after BA.(We will see you
every year for routine checks at no charge.) It’s like your mind incorporates
the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
You can try on implants in the office by
placing them into a special bra.The implant is also flattened somewhat when under
the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket. Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues.Multiple measurements need to
be taken to fit an implant to your exact anatomy. Have your surgeon's
office show you the charts of the implant dimensions for the various profiles
of silicone and saline from the manufacturer. Then you and your surgeon
can piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan.Keep in mind
larger implants tend to have more problems over the years.Since silicone implants wrinkle less than
saline implants, they might be your best bet.You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra.Wear this around the house for a while, and
see what you think.Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
Multiple measurements of your chest wall
are taken (seven in total). Implant size
selection has been an issue of much discussion. Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape. A photo album of patient
pictures is maintained to assist them. These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery. In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover.Finally,
your verbal requests are factored into the analysis. We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals.It is a surgical procedure that
uses special instruments and techniques to minimize tissue damage and avoid
touching the ribs. It causes far less trauma to surrounding tissue than
traditional approaches, and it dramatically reduces pain and recovery time. In
published studies of BA patients, 95-percent of women interviewed after the
procedure returned to normal daily activities within 24-hours. Quick-recovery
BA is not a “gimmick.”These specialized
techniques, which actually speed recovery and get you back to your daily
routine, kids and work, are published in our plastic surgery journals.Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons). Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year. Be sure the PS has been in practice for a
while, about 20-years might be a good gauge.Does the PS offer all three incisions?Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach."Ask to see their before and after photos if you didn’t see any on their
website. If they are experienced, they should have several 100 breast
implant patients for you to view. I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you. You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center. Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.All the best, “Dr. Joe"

I think you have chosen a range that fits you well. There is no right or wrong choice when the difference is only 15cc's. That is only one table spoon. When I have a patient trying to decide between adjacent volumes such as this, I always suggest the larger implant. That way you will not wonder if you would look better with a little more volume. Hope this helps and good luck!

It depends on your personal preference. You have to like them and live with them so ultimatley the choice is yours. They are both great sizes. Regards, 

Hello! Thank you for your question. In general, implant size does not correlate with bra cup size. The cup size itself will vary from manufacturer to manufacturer as well as who is doing the actual measurements. Thus, cup size is never a reliable indicator for your breast size. I typically encourage my patients not to communicate her desires in cup size but more on the actual look and appearance. Good communication between you and your surgeon of your expectations is warranted - choosing your surgeon wisely is the first step. Discussion of your wishes and having an honest and open dialog of your procedure is mandatory (e.g, implant type, incision, placement, lift, etc). I have found that photographs brought by the patient is helpful to get a visualization of the appearance you wish for in terms of size, shape, fullness, etc. A preopertive sizing kit is helpful in my practice. In addition, your surgeon's pre and postoperative photographs should demonstrate a realistic goal for you. Once this has been accomplished, allow your surgeon to utilize his/her best medical judgment during the procedure to finesse the best possible result for you after preoperative biodimensional planning and fitting the right implant for your breast width. Hope that this helps! Best wishes for a wonderful result!

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!

Dr. Schwartz

Thank you for your question. It is difficult to suggest sizing without examining your breasts (as no breasts are exactly the same) and evaluating breast measurements. That being said, I don't think you'll see a major difference in a 346cc and 360 cc implant. Good luck!

You are correct, you don't want them too large for your frame.  If they are too large you will start to look heavy instead of shapely.  The actual difference in the two implants you are choosing is quite small so I wouldn't worry about it too much.  Your surgeon should have your measurements and be able to help you pick. I have my patients narrow down their choice and then provide me pictures of how they would like to look.  Then I can make the decision in the OR as to which implants best matches their desired look.  Another thing to keep in mind is that the implants will typically look a little smaller once they are inside you body.  Best wishes!  

Thank you for the question. 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.  
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 we have time for a you their stuff's's homewith 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 know words such as “natural” or "C or D cup” or "too big" 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 for petite patients) helps. Best wishes for an outcome that you will be very pleased with.

Thanks for your post. The real difference in volume between those two is actually very small. However, you can definitely see a difference in the photos. I think either will be appropriate for you. I tend to err on the side of choosing the larger of the two in question, because it is much more common to have patients tell me they "wish they had gone bigger." Good luck on your surgery!

Hi,There is little chose from between the 2. It really depends what the best fit will be - this is based on your chest measurements taken pre-operatively, notably your breast width pre-op. In my practice, I use sterile breast sizers, which are then used on-table to establish your optimum implant. Here again, breast pocket width is the most important measurement. Either of the 2 may fit well. Good luck with your surgery.