Not sure what size to go. 425-475cc's? (Photo)

Why not "try out" both sizes and see which look you like best? If your surgeon doesn't have gel inserts then try the at home rice method (1oz rice = 30cc breast volume, place in baggies, put in your bra). Best, Dr. Nazarian

It is very difficult to determine 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 350 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. . 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 below link:#ChoosingBestImplantSizeandShape

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

Dear Antoinette BriThank you for your question and photos!The difference in volume of implant is 10% of the total volume- SO, split the difference and go with a 450 cc implant.  The implant will make your areola larger- thus you may want them reduced.With Warm RegardsTrevor M Born MD

Perhaps the biggest unknown in breast augmentation is how to get the proper implant shape and size. Sometimes, the correct volume implant will still be wrong because the projection, width or overall shape does not fit the patients anatomy. Proper sizing requires effort on the part of the patient and doctor.1Patients should get photographs of their desired outcomes. They should also perform the Rice Test (see below) at home to be certain that they are in the right ballpark for volume (but not shape - that is left to the surgeons exam and discussion).2Physicians should spend time to discuss all options with the patient. The exam should also establish the basic anatomical requirements for the implant and procedure. For example, is the patient asymmetrical, is there sagging, are the breast tuberous, is the chest wall narrow or wide?If the communication between the patient and doctor is lacking, then seek out a more proactive physician.Rice Test - 1Get a pair of disposable pantyhose, rice and a metric measuring cup (ml's=cc's).2Pour the desired volume of rice into each pantyhose leg. Cut off the extra material and tie the pantyhose in a knot so that the rice is secure. 3Put each bag of rice in your bra to determine if this is the desired volume enhancement. If the volume is too much or too little, untie the knot and adjust the volume of rice accordingly. Repeat this process until your are happy with the volume of rice - at this point, pour the rice from each bag separately into the measuring cup and record the volume in ml's. Remember to record each breast separately because of the asymmetry you may have. 4The ultimate volume will be about 10% higher than the volume of rice measured. If you have any further questions, please refer to my book "Cosmetic Breast Surgery - A Complete Guide From A to Double D".

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 implant.

There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 32 C-D and a 38 C-D 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

Dear Antionette bri,As you already know, your anatomy and size you select have a big influence on the ultimate look. Other factors are the type of implant (silicone is a good choice), profile of the implant (whether is is wider and less projecting, or more narrow based and more projecting for the volume desired),  and the shape (round or anatomic, which are also available in a variety of dimensions). If you have the ability to to three dimensional imaging (like with a Vectra system) I have found that to be a very helpful tool and patient's initial preconceived ideas of what they think they would like often change based on what they see. I kind of get a "I told you so!" moment when it comes to getting a more natural look.Anatomic implants have not been fully embraced by the majority of surgeons in the US, but I have really liked them for patients with a wider cleavage who are concerned about getting too much upper pole fullness. The feel and mobility are a little different, but I have been quite pleased. Also, when it comes to the final size selection, I will always order a size range (a little bigger and a little smaller) so I have options intra-operatively of fine tuning to focus on a patient's priority when it comes to the look naked. I would never expect my patient to do this for me. They put me in the ballpark, but the final choice is made while you are comfortably sleeping.Best of luck to you!

In terms of picking the right implants to
achieve your
goals, generally speaking, I consider two
factors when selecting implants for my patients:1. Dimensional planning2. Gel Implant Sizing systemDimensional
planning – The measurements of your chest wall are taken. Also, the
breast dimensions including the height, width, and current dimensions of
each breast form the basis of dimensional planning. Based on these
measurements, the implant size is recommended. This will give you a
unique breast implant that is suited for your body frame. However, there
are some limitations of what size we can recommend. For instance, some
implants may just be too big for a narrow chest wall. Your surgeon can
review this with you during the consultation.Gel Implant Sizing
system – During the preliminary breast implant consultation, you will
be provided with an option to “try on” a variety of implant shapes and
sizes. You can also visualize the possible outcomes of your surgery
which helps you to get that perfect size to give you the shape that you
longed for. This way your preferences are known and you can then pick a
range of implants that will “fit” just right to give a soft natural
fuller look. Hope this helps.Dr. BasuHouston, TX

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. There is no accurate/reliable/predictable correlation between size/profile breast implant utilized and cup size achieved.  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, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) 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 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 know words such as “natural” or "full C 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.

That is not a bad choice of size, but based on the breast size dimensions from the Vectra image I will suggested that a 450-475 mL implant will give you a D-DD. I would suggest that you try those implants on and see what they look like. You say you would like to be a C cup and you show pictures that describe a nice natural C cup look however I think a 450 size implant will be larger and looked larger than your wish pictures. I think it would be very important to try those size implants on and see what they look like when you are wearing them.Good luck!