I would ask your doctor to use sizers to determine if 450 cc is even possible. Sometimes the size you choose pre surgery does not provide the results you see once placed. Most gel implants have a sizer which can be placed during surgery. I would let your surgeon make the decision after going through these steps.
It is very difficult to determine the best lift you will need (recommended based on your photos) or 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 300 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. The same process goes for just filling in the upper part of your breast without becoming much larger. 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 link below including silicone vs saline implants
You will need to ask your Plastic Surgeon to approve a larger size for you based on your measurements. If 425 was already pushing your limits they may not want to increase it. Keep in mind that 25cc is a very small difference either way so if you can safely do it- great, if your surgeon feels that it wouldn't be advisable and 425 is your largest then rest assured you will get the fullest look you can while remaining proportionate. Cup sizes can't be accurately predicted but those volumes on a 34" rib cage typically result in a D cup of some sort.
All the best
If you want 450cc implants instead of the recommended for 425cc, discuss this with your plastic surgeon. Judging from your photographs, a 450cc implant would not be too large.
Regarding size, most patients would opt for a larger size if they had it to do over. Not all patients, but most patients. However, there is very little difference between a 425cc and a 450cc implant.
Thank you for your question and photographs. Best of luck to you.
Thank you very much for enquire.
After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) Breast Augmentation.
I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection, and 550ml will be excelent on you, to fill the breasts properly.
Dr. Emmanuel Mallol Cotes.-
have you looked into gummy bears? High profile shaped implants give you an augmented but more natural look. You can't limit your selection to round implants if you want "a slight sag"...
I appreciate your question.
The size of implant 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!
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
Thanks for the question. I wouldn't imagine a problem if you discuss this with your chosen Plastic Surgeon. An increase in size of the implant might be possible. In my practice, the important question answered at the time of surgery is to view what size implant that accommodates to your breast measurements will fit properly in the pocket. There may be some margin for discussion about what size might be considered, and this conversation should always happen now before you have your surgery performed. In breast surgery size matters, but in this case what fits into the pocket really matters!
Good luck to you.
Frank Rieger M.D. Tampa Plastic Surgeon
Hi and thanks for the photos and question. It is really not possible to give meaningful advice on sizing without a face to face consultation and measuring your actual breasts, chest wall and soft tissue envelope. There would be lift;e or no visible difference between a 425 and 450cc implant in most people but the dimensions between these volumes in different manufactures may be significant which will affect the shape and projection of your breasts. The amount of sag, width and projection does not just depend on the implant choice but on the amount, elasticity and dimensions of your own body.
If your surgeon is a fully qualified, Specialist Plastic Surgeon (Board Certified Plastic Surgeon), they should have measured you and assessed the best implants to deliver what you are looking for from Breast enlargement surgery.
I hope that helps.
Best of Luck.
Dr Mark Hanikeri MBBS, FRACS
Perth Specialist Plastic Surgeon
It's unfortunate that your consultation an pre-op were not completely satisfying-- they should be. In my hands-in a case like this- I would recommend the latest silicone implants- Inspira. After careful sizing with this implant, and proper placement of the implants with the least visible scar- you will have the highest potential to achieve your wish pic goals. It is worrisome that you are still uncertain about your best path. We address the cup size video in a video here: