Should I get 200cc or 250cc implants? Or larger? (photo)

Question

Hello, 5'8", 125lb, 32yo I want small breasts that maintain my slim shape (large B, small C - see photos) PS advised no smaller than 250cc due to chest width, but 250 sizers felt enormous. 200cc were comfortable. I have ordered: Mentor, smooth round, moderate plus profile in 300, 275, and 250; moderate profile in size 200cc. Will a 200cc implant be too small? Would a 250cc moderate profile implant be a better compromise? Or are both way too small? Any guidance much appreciated!

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.
The key is to respect your BWD. It is impossible to say for certain whether a 250 cc implant will deliver a B/C. Too small is a relative question. That being said the key is to respect your BWD. I would not struggle over a 50 cc differential (slightly more than a shot glass), as this is unlikely to make a dramatic difference in outcome. Both of your choices seem reasonable.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

Stephen M. Becker, MD · Answer

While there is no way to predict with 100% accuracy how your breast will look post-op, I would hope that a thorough exam and measurements were done to choose the best implant for your breast. Being 5'8, you could maintain the 250 cc implant. I am sure your surgeon will take the time to make sure you are happy, helping you choose the appropriate implant for your aesthetic desire. All of us want to make sure our patients are happy and 100% comfortable with the procedure. If you have additional questions, contact your surgeon. I'm sure they won't mind talking with you.

Pejman Aflaki, MD · Answer

Hello and thank you for the question.  An in-person consultation is needed to give you a useful advice and I would suggest that you discuss this with your plastic surgeon. In a typical consultation, you try a variety of in-bra sizers and in combination with several other measurements that your surgeon will do, the final implant volume is selected. In-bra sizing tends to under-estimate the final volume because of the extra-volume of the bra and the superior displacement of the breast tissue. So, I would usually go slightly larger. Use of 'goal pictures' is  also an effective way to communicate your goals with your plastic surgeon. My best advice is that you communicate your goals and aesthetic ideals with your surgeon as clearly as possible and trust your surgeon's skills and abilities to deliver what you are looking for.
Best wishes and good luck,
  
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Kenneth Hughes, MD · Answer

The varying profiles among implants means that same amount of volume will create a different look in a low profile implant as opposed to a moderate or a high profile implant. 
None of the modalities to approximate final results from breast implants are 100% accurate; they merely facilitate the patient and the board certified PS concurring on the size and type of breast implant which will come the closest to reaching the patient's goal. My patients prefer to try on sizers under garments they typically wear to determine if they fit as expected and help allay some of their trepidation associated with this decision.   Recommend that you follow the same procedure with the moderate plus profile in 300, 275, and 250 and moderate profile in size 200cc. I would recommend that you go with that size that boosts your self-esteem, and fits your anatomy.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  It appears that your goals can be approximated but unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. It sounds as if it may be wise for you to "try on" several of the implants so that you can have a better visual representation as to what they would look like.  Best wishes

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Should I get 200cc or 250cc implants? Or larger? (photo)

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Answer: Should I get 200cc or 250cc implants? Or larger? (photo

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