Is 550 CC & 500 CC of silicone a noticeable difference? (Photo)

The difference between 500 cc and 550 cc is very minimal. The bigger issue, in my mind, is the different shape and nipple positions of the breasts. The left nipple is lower, and that breast has more skin laxity/excess. You might want to consider a minor lift on the left to bring the nipple heights to a similar level, and to equalize the skin laxity. You could use the same size implant on each side, with expectations of improved symmetry. If you simply try to put a bigger implant on the smaller but tighter side, and a smaller implant on the larger but looser side, your asymmetries will likely persist. I think you're better off making the skin and soft tissues more similar, then using the same implant volume on each side. Yours is an ideal situation for a circumareolar lift with an interlocking suture, resulting only in a scar around the areola. That is an excellent lift when the nipple needs to be raised 1-2 cm with mild skin tightening, as in your situation, but not a good lift for more significant drooping.Best wishes!

One must be careful using different sized implants to correct breast asymmetry. Unless one addresses the soft tissue breast asymmetry, it will persist and often worsen. For example, your right breast is smaller and if one places a larger implant it it, without lowering the inframammary fold, it will be higher, seem larger,  and more protuberant out of the top of the bra/clothing. Conversely, if one lowers the fold, then the nipple will seem too high and face upwards from the implant mound. So I urge you to really discuss the asymmetry with your board certified plastic surgeon so that your expectations are reasonably achieved.

Hello, there is only about a 10% difference in the size of the two implants you are considering, so the final result with either implant would likely be fairly close.  Your PS is in the best position to advise you about your implant selection because they have your breast dimensions.

50 ccs is such a small amount of silicone that it won't make a big deal of difference, whichever size you choose.That being said, it sounds like you have chosen an excellent plastic surgeon since I totally agree with your plastic surgeon, you would be best served by putting a silicone breast implant in through the armpit partially under the pectoralis muscle.  From the excellent picture you sent to RealSelf, it would appear that you need an implant of a reasonable height to not only fill up the bottom of your existing breast, but also be high enough to allow the nipple to fall at about 40-45% of the height of the implant once it settles into your breast pocket.  Rippling of an implant is related to the thickness of the implant shell, the thickness of your skin, subcutaneous tissue, and pectoralis muscle.  If these are all thick, then any implant of any size large enough for the pocket would be appropriate.  Since the shell of the Mentor implant is thinner, I tend to avoid using that implant in people with minimal breast tissue who have had multiple pregnancies.  Also, I shy away from moderate plus implants since they are underfilled by both American manufacturers, and therefore tend to show traction rippling no matter what size implant one uses.  My not so short answer to your question is, if you were my patient, I would tell you not to worry about the difference between a 500 and 550 since the difference is miniscule, and as far as rippling is concerned, I would recommend a second consultation with your plastic surgeon to determine the thickness of your tissue and to discuss the thickness of the implant that you are going to have used in your augmentation. 

Without examining you it is difficult to know what will be best for you but in general terms there isn't a huge noticeable difference between 500 and 550 once they are implanted. Talk to your surgeon about your concerns before surgery. Best of luck! 

Hi Elaine,Please see the excellent answer below by Dr. Pousti. I agree, you would want to return to your PS and put some finishing touches on your plan.  You may want to consider an implant that is 50cc larger on your smaller side.  Also have the people in the office check you standing up and leaning forward, and secondly while lying on your back, and have them take photos in these positions, to nail your difference down.  Take a look at the video below for sizing and the web link below for axillary incisions, hope this helps. The bigger you go, the more chance of rippling because the tissue thins out more over a larger implant.  I have inserted 650 cc through the armpit so that is not an issue.  For you, I would say you are going with some pretty big implants.  So work it through a little more.  All the best, Dr. Joe

Hi Elaine, thank you for your question
on which implant size would be best for you.
Right now it sounds like you’re considering 500cc and 550cc. Since there is no way to say definitively
over the internet which size would be optimal for you, take comfort in the fact
that the surgeon uses your unique measurements and is able to provide you with
a general range. In many cases the board
certified plastic surgeon can best be your guide as they’ve met with you in
person and heard your aesthetic goals. You may consider doing 3-D imaging;
however with nearly all the breast cases we’ve performed, we’ve found patients
enjoy doing a live “try on” session where they actually can “try on” the
implant in a non-padded bra in our office.
This does not give an exact measurement of outcome, rather it gives a
nice idea of what to expect. For patients who desire a more natural look we
like to recommend the shaped implant.
For patients who desire a more full, voluptuous look we recommend a
higher profile implant. And remember that all breasts have at least some amount
of asymmetry (we like to say they’re like sisters and not twins). My very best to you. – Dr. Brian Coan

There is a minimal difference in the clinical appearance of the 2 sizes.The best cosmetic result in any
particular breast augmentation patient depends on a variety of factors,
including: Your individual anatomy, 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, breastdimensions 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 D and a 36 D are significantly different. Cup size
varies from manufacturer to manufacturer and even within styles from any
particular manufacturer. Nor is there a direct correlation between implant
shape or size and 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

Thank you for your question. To give you any meaningful advice requires
an in-person consultation. 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

The most common complaint after breast implant surgery that I hear is that the implants are not big enough.  So, when choosing between two sizes, I usually recommend the larger size.  You may consider high profile implants which wrinkle less and tend to fill up the loose skin envelope better.Good Luck!