Is It Better to Overfill Smaller Breast Implants?

I am 5'7" and about 124lbs. I can not determine the size of Breast implants I should I get. I'm an A cup and want full breast. I would like a large C to small D. I tried on the 425cc and loved them. I'm going under the muscle and the doctor said high profile.

What size will I be after this and should I get 400cc implants and overfill to achieve my look or get 425ccs and overfill? This whole thing is confusing and stressful. Also, If you don't stop smoking are there really bad effects? Thank you.

Doctor Answers 14

Problems can develop with saline implant overfill

A saline breast implant is designed to have an acceptable fill range or volume. For a 425cc saline breast implant it may be possible to fill the implant to 475cc and stay within the fill range without loss of performance. If the implant is 'overfilled' the silicone rubber envelope will be under increased stress and the life of the implant may be shortened.

Also, the implant will round up and stiffen and lose the soft feel and natural shape. The edges will 'scallop' or form small waves of folds which may be apparent if the breast coverage is thin. The best results will occur when the appropriate implant is selected by the surgeon, and used according to how the implant was designed.

Saline implants are a wonderful product and work very well when matched to the right patient. You can have a smaller concealed scar, avoid leak worries, reduce breast capsules. When breast cover becomes thin, or the implant required becomes large, perhaps 450cc and over, a silicone gel implant may be a better choice.

Spend plenty of time considering choices and trade-offs before settling, and don't expect the implant you tuck in your bra to look and feel like your actual augmentation result. It would be nice, but implant selection is not that easy. Never underestimate skill and judgment.

Best of luck,


Chicago Plastic Surgeon
4.0 out of 5 stars 38 reviews

Impalnts and cup size

It is hard to predict the exact cup size for you after getting implants.  A 425 cc implant may get you in to a "D" cup.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 22 reviews

Determining breast implant size.

There are many ways that plastic surgeons determine what size to put in.  Some will have the patient place sizers in a bra they want to fill out.  Some will make that determination on the table.  Patients will also sometimes bring in photos of breasts that they like and see if it is a reasonable goal.  Some patients are very specific as to how many cc's, profile, etc, (mostly because that is what their girlfriend got...)  I tell patients to please don't fall in love with a particular cc.  It all depends on them.

The most accurate that I have found is measurement of the base width.  Using this measurement, the plastic surgeon can get an idea of what size the patient should be.  I will usually bring in a size above and below into the O.R. with me.  There is a dynamic interaction between the chest wall, soft tissue of the breast and the implants themselves.  Judgment is often used at time of surgery.  Sometimes "overfilling" of the implant is warranted, (they actually have a fill range).  It all depends on the individual.

Make sure your board certified plastic surgeon knows your goals before you go to the O.R.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.5 out of 5 stars 14 reviews

Implant sizing for breast augmentation

It is very difficult for a patient to pick a specific size, and for this reason I recommend that you speak with your surgeon directly about your concerns regarding sizing. It's hard to predict exactly what size you will be after surgery, as bra cup sizing differs so much from one manufacturer to the next. Regarding overfill of the implants, with either size I would recommend slight overfill to prevent rippling of the implants. With silicone implants, there's less chance of rippling and frankly a more natural feel to the breasts. I agree with staying under the muscle. Finally, keep in mind that your risk of complications goes up with smoking, including bleeding, infection, capsular contracture, and anesthesia risks. If you can quit for 2-3 weeks prior to and after surgery, your course will be much smoother. Good luck.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.5 out of 5 stars 6 reviews

Better to "overfill" breast implants

You may get some different opinions on this on issue, but in doing over 1000 breast augmentations, I have come to the following opinions.

1. Saline implants do not feel as good as silicone but are still an acceptable option for most women. Be sure to know the pros and cons of each. Most women with saline are happy with their results.

2. There is a role for all profiles of implants (low, medium and high). The profile choice is best chosen by the surgeon that best fits your frame for the given size implant you choose.

3. Filling saline implants to the upper level of the fill range will increase the lifespan of the implant, not decrease it. Filling to the lower fill level leaves more fold ceases in the implant, which is where failure of the implant usually occurs.

Be informed and know your choices. Ask questions and be wary of anyone who tells you there is only one option or "right" way to do this. Good luck.

Dean Fardo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 11 reviews

400 cc's are not "smaller implants"

You will probably be happier with gel as the salines will ripple laterally if you lean forward even under the muscle. Also, HP implants create a very specific "look" and you need to be sure you like that look because it certainly isn't "natural." I'd advise visiting at least 3 qualifed plastic surgeons and seeing what they recommend.

Confusion in Breast implant sizing for breast augmentation


My primary concern with any breast implant is your overall bodyweight and relatively thin soft tissue coverage. I tell patients to imagine a baseball covered with a silk sheet: you will see everything. Well looking at you, your bones are clearly visible.

Your natural tissues cannot even conceal your own bones so how can they conceal an implant, which is placed above the bone level?

  1. Placing your implant under the muscle is a beginning
  2. Staying with a reasonable sized implant is another
  3. Considering high profile to limit rippling may be beneficial
  4. Use of silicone implants may enhance the natural look and feel

If you like the 425 sizers on, then using a final fill of 465 to 485 will achieve relatively comparable results when placed under the muscle.

Smoking will not only effect the appearance of the scar but will make your recovery from general anesthesia more difficult.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 69 reviews

Choosing the correct size of breast implant

There are generally 3 methods of choosing the correct size of breast implant for an individual.

1)The first method involves taking a number of standardized measurements of the breasts. These measurements are then transferred to the manufacturers charts and the "correct" size is then determined. This often gives a conservative recommendation with the largest size on the chart rarely above 350cc.

2) The second method involves trying on sizers. This gives the opportunity for the patient to see what she will look like after surgery. Most patients prefer this method as gives them what they want.

3) The last method involves 3D imaging software which gives the advantage of seeing what the breasts will look like with the chosen volume of implant. This is new technology and depends on the accuracy of the software.

The advantage of silicone is that in real thin individuals it will feel more natural and there will be less risk of rippling. If you choose saline, I would go with moderate plus implants 400 cc overfilled to 450cc. This will give the appearance of 425cc implants.

Robert M. Jensen, MD
Medford Plastic Surgeon
5.0 out of 5 stars 39 reviews

Fill volume for saline implants

First, for the size range you are considering I agree with Dr. Teitelbaum that silicone is a much better choice than saline. One thing that is helpful in thinking about saline implant fill volumes if you do decide to go that route is that 5cc = 1 teaspoon, so we are really talkning about very small increments in terms of 400 vs. 425. Saline implants have a nominal (minimum) fill, the stated size of the implant, and most surgeons will add more. that is because at the minimum fill the implants will be too ripply.

However, the higher the overfill, the firmer, rounder, and more unnatural they become. Regarding the smoking question, the reason why it is good to quit before (and after) surgery is that nicotine constricts blood vessels, leading to poor blood flow to the healing tissues. There are some procedures (facelift, breast lift, tummy tuck) where it is an absolute requirement to quit because the potential problems with healing are so significant.

Richard Baxter, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 41 reviews

It is better to overfill the saline implants

If you are not sure about the size of the implant, you can try 3D imaging. I've been using this program to show my patient the size and shape of their breasts with different implants. You can find a local plastic surgeon who offer this service. There are 2 programs, Axis 3 and Canfield that are used for morphing.

Saline implants are designed to be over filed and your doctor will adjust the amount of the over fill during the surgery.

Please stop smoking at least 2 weeks before and 2 weeks after surgery for optimal result.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 100 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.