Is 600cc too big of an implant for someone my size? (Photos)

Question

I am 22 5'5" and weight about 180 pounds when I went in for my consultation my favorite size was 550/600 but is that crazy and way too big?? I have wide hips and a big butt so My thinking is that it will just be more proportionate. I'm just looking for another opinion I guess, the picture I attached is awful I should have worn a tight fitting shirt that wasn't black for this. I am a small B cup right now and wanting like around a DD thank you.

Joe Gryskiewicz, MD, FACS · Answer

Hi Chy!  Usually, as I write below, it is 200cc per cup size, so to put a B to a C = 200, to a D = 400 and to a DD, which you want, a 600cc.  So I believe you are on the right track! But remember, this is art, not arithmetic!! Here are a few tips for you because this is perhaps
the hardest decision for a patient to make, as well as the surgeon.  Also see the video attached to my answer.  We spend up to two hours for our BA consults
to be sure there is careful communication. We do a full exam in front of a
full-length mirror taking six exact measurements.    We
put your photos on a large computer screen for imaging, and go over your
“ideal-size” photos. We then save this information to your password protected
“web account.” 
     First and
foremost the implant should fit the dimensions of your breast and tissue cover.
 Balancing the implant to your
over-all body shape and tissue cover is essential.    The main thing is to
have the diameter of the implant fit the diameter of your breast "foot-print".
 Higher profile implants tend to have a smaller diameter.  Higher is really a marketing term, but often
translates into the same volume implant with a narrower base.  Saline implants actually tend to decrease in
diameter as they are inflated!  The average size chosen over our last 7,000 breast implants was
“350cc”.  BUT, 90% of our patients tell us they wish they were
bigger a year after BA.  (We will see you
every year for routine checks at no charge.) It’s like your mind incorporates
the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
 You can try on implants in the office by
placing them into a special bra.  The implant is also flattened somewhat when under
the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket.  Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues.  Multiple measurements need to
be taken to fit an implant to your exact anatomy.  Have your surgeon's
office show you the charts of the implant dimensions for the various profiles
of silicone and saline from the manufacturer.  Then you and your surgeon
can piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan.  Keep in mind
larger implants tend to have more problems over the years.  Since silicone implants wrinkle less than
saline implants, they might be your best bet.
     You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra.  Wear this around the house for a while, and
see what you think.  Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
 Multiple measurements of your chest wall
are taken (seven in total).  Implant size
selection has been an issue of much discussion. 
    
Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.  Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape.  A photo album of patient
pictures is maintained to assist them.  These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery.  In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover.  Finally,
your verbal requests are factored into the analysis. 
     We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals.  It is a surgical procedure that
uses special instruments and techniques to minimize tissue damage and avoid
touching the ribs. It causes far less trauma to surrounding tissue than
traditional approaches, and it dramatically reduces pain and recovery time. In
published studies of BA patients, 95-percent of women interviewed after the
procedure returned to normal daily activities within 24-hours. Quick-recovery
BA is not a “gimmick.”  These specialized
techniques, which actually speed recovery and get you back to your daily
routine, kids and work, are published in our plastic surgery journals.  Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.  
     Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons).  Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year.  Be sure the PS has been in practice for a
while, about 20-years might be a good gauge. 
Does the PS offer all three incisions? 
Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach." 
Ask to see their before and after photos if you didn’t see any on their
website.  If they are experienced, they should have several 100 breast
implant patients for you to view.  I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you.  You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center.  Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.      
All the best, “Dr. Joe”

Jaime S. Schwartz, MD, FACS · Answer

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
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Sean T. Lille, MD · Answer

Choosing an implant must be individually tailored to the person. I like to guide a patient and help provide a range which is dependent on the width of the breast, the location of the breast footprints on the truck and the elasticity of the breast skin. All these parameters help me provide a range for the patient so they can choose the best volume for their size. Without knowing all those parameters, it is difficult for me to determine your best ranges of volume. Good luck!

Stuart A. Linder, MD, FACS · Answer

The photograph provided does not allow for an accurate estimate of volume or sizing of the implant. Best of luck. Seek several breast specialists for consultation in your area

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  600cc is a large implant, but it depends on your breast and chest wall anatomy.  The size, profile, and shape 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

Donovan Rosas, MD · Answer

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.
With regards to your specific question, as long as you are staying within the parameters defined by your measurements you should be fine. That being said, 600 cc implants are very large (on most frames). Without measurements (or better photos), it is difficult to offer any guidance. Remember: The larger one chooses to go when selecting an implant volume, the greater the incidence of complications. Larger implants will also age your result more rapidly as there will be greater support demands placed upon your native tissue.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Daniel Barrett, MD · Answer

Dear chy1410,Determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. We have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements. Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If its too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match. Of all of my breast augmentation patients, everyone of them have been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the best size 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 implant

Shaun Parson, MD · Answer

Thanks so much for your question. I think there's a lot of thought and science that goes into the sizing system. So if 550cc sizer seemed to work OK on your frame I would trust that system. Based on your height and weight it sounds like a 550 to 600 mL size would work just fine. I agree it's difficult to tell exactly based on your photos or without at least seeing you in person. But hopefully that gives you a little bit more assurance that you're making the right decision. Good luck.

Curtis Wong, MD · Answer

and if sizing with 550 cc sizers looked good to you, then 600 cc implants will be fine... but if you plan to change weight down the road, things can change slightly, depending on where you lose your weight.  If you are simply maintaining your weight and that is the plan, go for it if it looks good on you!

Is 600cc too big of an implant for someone my size? (Photos)

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