Is 485cc moderate, silicone, behind the muscle too large for me at 5'9, 160lbs with a large chest wall? (Photos)

I appreciate your question.

From your photos, it appears that you would also benefit from a  breast lift.  A breast lift would reposition your nipples and reshape your breasts, giving them a more youthful appearance.

In terms of implant size, 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



Board Certified Plastic Surgeon



Director-Beverly Hills Breast and Body Institute



#RealSelf100Surgeon



#RealSelfCORESurgeon

Thank you for your question. Based on your photos, you appear to have a nice starting place and should have a nice result with breast augmentation/lift surgery. The most important factor when sizing implants, is working closely with your surgeon in person to find the implant size that gives you the look that you desire. Careful measurements of your breast and chest wall will help determine which size implants will fit within your natural breast footprint. Taking into account your desired look, and your measurements, an implant is chosen that specifically fits your body.

Unfortunately, online recommendations are not that helpful. Make sure that you have a good relationship with your plastic surgeon, so that you two can work together to find the right size.

In my office, patients try on implants in a bra and clothing. There able to see how they look in the mirror, and in photographs. Women are also encouraged to bring in wish pictures, so that I can get a sense of the look that they would like to achieve.

Good luck with the process!

Hello and thank you for your question. You are a great candidate for a breast
implant with a lift.  The size of the implant is based on your desired
breast size/shape, your chest wall measurements, and soft tissue
quality.  This decision should be based on a detailed discussion
with equal input from both you and your surgeon.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Only you can tell whether 485 cc is too big based on the look you are trying to achieve.  Using implant sizers and 3D imaging can help you get an idea of what volume you may want.  Your plastic surgeon should also be able to advise you on the different implant sizes and profiles based on the base width of your breast and the look you desire.

and not look excessively large.  If you want perky, then you need a lift.  Otherwise, you could always stage this and get your implants first and then decide if a lift is really needed or not.  You need implants at least as wide as your breast footprint, if not a little larger to work on the space between the mounds.  Make sure your surgeon understands your goals and expectations as that is all that really matters... surgeons have opinions and should guide you to a happy outcome and if they cannot do it, they should refer you to someone who can.

You can try a baggy test and this will give you a rough idea. Depending upon the lift technique, you might have some tissue removed to shape the breast so that has to be taken into account.

In my opinion sizing a patient for implants can be simplified. Sizing is not about a number. In fact, I do not even discuss numbers with my patients. If a patient walks through the door and says they want x-cc implants I have to educate them about how sizing works. The best analogy I can relate this to is buying shoes. When you go to buy shoes how do you do that? First you start with the size your foot is right? So if your foot is a 6.5 you try on all kinds of 6.5 size shoes. Some may be tall, some might be flat, and some might be somewhere in between. You would never try to buy a size 8 shoe because it would be too big for your foot right? Breast sizing is the exact same way. Implants come in several different profiles that are like different heights of shoes. Implants can be low profile, moderate profile, or high profile. There are even implants that are higher than high. That would be your high platform shoe. Each implant style give you a different look. Now, your breast has a defined width that we call the base diameter of the breast. This would be analogous to the show size. Your breast base diameter never changes. It is what it is. So now, you can choose several different style of implants that fit the number of your breast base diameter. That really narrows down what implant is best for you. So once you know your breast base diameter you can try the low, moderate, high or really high implants on. The only think you have to decide is which look you are going for. You would never put an implant that is 13 centimeters wide in a patient whose base diameter is 10 centimeters. Half the implant would be in the armpit. So, this is very simple to me. My patients get a few choices that fit their breast and that is it. I will not put an implant in a patient that is too wide for their body because it will harm them over time. Hope this helps.

Thank you for the question and pictures.  Based on your photos, you are starting a good place and should have a very nice outcome with breast augmentation/lifting surgery. ***Given your concerns, and the fact that your surgery is coming up soon,  you will do well spending additional time with your plastic surgeon communicating your goals, questions, and concerns ( preferably prior to the day of surgery). In other words, careful measurements, dimensional planning, and careful communication will be key. 





Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery.  Breast lifting involves some removal of  breast skin envelope; there may be limits as to how large of a breast implant can be utilized safely.   











Generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting 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. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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. I have found that the use of words such as “natural” or "too big" or "C or D cup" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase. 



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. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy. I hope this, and the attached link, helps. Best wishes.







 












 

"Too big" is a value judgement but put various sized implants in a bra till you see the volume on your chest that you like.  The surgeon can then pick the best shaped implant with that volume for you based on your measurementsDr Corbin

Your best bet when you are trying to decide on implants is to try on sizers of the exact implant you are considering inside a very tight sports bra. This will give you a close idea of what you will look like. More importantly the dimensions or width of the implants need to match and fit your frame and body. If you are working with a board certified plastic surgeon with an expertise in breast augmentation he or she should be able to help you with this in their office. Good luck! Dean Vistnes, M.D. Vistnes Plastic Surgery San Francisco Bay Area  #drdeanvistnes #breastaugmentationTweet