Will 490cc implants make a good difference in size from 385cc?

The difference is approximately 100 cc.  If you are size 32 or 34, each 100 cc corresponds to 1 cup size change.  If you are size 36 or 38, each 100 cc corresponds to ½ cup size change.  However, I am more concerned about the fact that you have capsular contracture.  This raises several questions: will the capsular contracture be resected or will you have the pocket switched to a different location?  Most people prefer to change implant location when a capsular contracture occurs, which means placing a pre-pectoral implant rather than retro-pectoral.  Pre-pectoral implants often look bigger and you may be able to get by with a smaller implant and still look better.Best Wishes,Gary Horndeski, M.D.

In general, 200 cc may increase you one cup size. However, there are a range of factors that will affect implant size. Women of greater stature may require more than 200cc to augment their breasts from a B to C cup. Women who are more petite, or who have very narrow frames, may require less than 200cc to gain an increase of one cup size.

I TELL PEOPLE WHO WANT TO GO LARGER TO GO UP 30-50%, OTHREIWSE THERE IS NO POINT. YOU ARE ON THE SMALLER SIZE OF AN INCREASE

Although the implant is considerably larger it will probably only seem a little larger. When you have hard capsules it makes the breasts seem larger than they are so getting caosulectomies and switching to large lr implants will be noticeably larger but not too much so.

Dear Practical894810,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

A 100cc difference will be a nice and noticeable increase without looking extreme. I would say this is generally about half a cup larger. Hope this helps!Johnson C. Lee, MDBoard-Certified Plastic Surgeon

Thank you for the question and generally a 100 cc difference will result in going up one cup size.   That said I would put sizers in a bra till you see the volume on your chest that you likeDr Corbin 

Dear Ms. Practical 894810,

Thank you for your questions. Unfortunately without measurements, evaluation of your skin elasticity and a exam of your tissues I can can only comment based your story and photos. However, I hope you find my following comments helpful.

There are many variables besides just implant volume. Here are some of the additional decisions that you and your Plastic Surgeon will need to make together:

I. Size/volume of implant.
A)Realizing there are no standard bra (strap/cup) sizes, purchase several bras (full bodied and no padding) of the strap and cup size you think you want to be.
B)take a measuring cup (1 oz=30cc) place rice in a nylon. Therefore 10 oz. = 300cc.
C) try on various volumes of rice with some form fitting clothes.
D) most women are NOT perfectly symmetrical either in volume, shape and nipple/areolar position. Usually differential sized implants can be used if there is a significant breast volume discrepancy (usually greater than 50-75 cc difference in volumes). Intra operative maneuvers can be used to improve nipple areolar and breast symmetry. If needed after the breasts have “seated” (final position) and if desired the nipple/areolar position can be adjusted under local anesthesia as a minor surgery in the office.

II. Profile of the implant
A) for the same volume the higher the profile the narrower the base width.
B)there is very little difference in the ultimate and final nipple projection or breast projection between profiles.
C) In my opinion the base width of the breast should equal the base width of the implant to eventually obtain maximum cleavage and prevent lateral (increased side) breast volume. Thus I personally chose the profile based on the patients chest measurements, (a high profile on a wide chest may not result in the cleavage desired and conversely a low profile on a narrow chest may result in implant in the outside arm area).
D)There are 3 companies that Most plastic surgeons have access to all companies. Allergan has the most profile choices.
E)Cleavage is largely determined by your anatomy. This can be optimized by choosing the best profile implant and postoperative implant displacement excercises towards the midline of your chest.

III. Shape of the implant:
A)for the vast majority of cosmetic patients I recommend what are referred to as “round” implants
B) for reconstructive patients shaped/form stable implants are often used because of acquired lack of breast tissue.

IV. Placement of Implant
A)decision of implant(subpectoral, dual plane, or suprapectoral) will be determined based on your anatomy and long term goals and benefits. Placement under the muscle and dual plane are associated with the lower chances of capsular contracture.
B) Location of the implant on the chest wall will depending on your specific goals ie upper pole fullness (high and “fakery”), neutral (full slope) or lower pole fullness.

Filler Material
A)Siilcone gel “gummy bear” filled implants feel most comparable to normal breast tissue, tend wrinkle less and are less palpable.

B) Normal saline implants can be adjusted in size intraoperatively, if ruptures normal saline absorbs, potential increase rippling compared to silicone gel, smaller incision to place normal saline implants as compared to prefilled silicone gel implants.

I hope you found the above helpful. Nothing substitutes for a person evaluation and discussion of your specific options.

I suggest you collect several nude model photos of the goal breast shape you desire and schedule several additional consultative appointments with experienced Plastic Surgeons or if you have chosen a Plastic Surgeon please make sure he/she is Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).
My best wishes



Robert Hardesty MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
Awardee RealSelf Top 100 & inductee in RealSelf Hall of Fame
wwwimagineplasticsurgery.com
4646 Brockton Ave
Riverside, Ca 92506
(951) 696-7600

Hello. 
Thank you for your inquiry and congratulations on your surgery!

There are many different factors that go into choosing a breast implant size which will correspond with your body dimensions while concurrently achieving your aesthetic results. Some of these factors are: Implant size (CC's), Implant profile (Low, Moderate, High), Placement of the implant (Subglandular vs. Dual Plane) etc. We utilize smooth round cohesive silicone gel 'gummy bear' implants for the best results. 

During a consultation your aesthetic goals are heard and taken into account with the measurements of your breasts and the integrity of your tissue, as well as level of ptosis (sag). From here we collectively can find your 'perfect fit'. 

You are able to try out sizers and different implants in our office such that you can get an idea of what size you would be post-operation. We also offer Crisalix 3D plastic surgery virtual simulator during our in-person and virtual consultations to preview potential results. After your consultation, you will receive your very own implant sizers to take home with you (at a small cost) whether or not you decide to go forward with your procedure.

 I usually recommend that my patients stop smoking, take vitamin C daily, and avoid aspirin/ibuprofen and vitamin E 3 weeks prior to surgery. 

I specialize in the 24-hour Recovery method which minimizes trauma to the breast and decreases pain post-operatively.

Please note that this response does not substitute patient-doctor relationship.

We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.

During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery.

We invite you to come in to discuss your options more thoroughly.  Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!

M.Kara,MD,FRCSC (27+ years experience)

- Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind