What size implant should I get? (Photo)

I am 34 yr old. I am 5'6 190 lbs. I had weightloss surgery in 2013 and lost 100 lbs and have kept ot off. I am having a break reconstruction and augmentation along with a tummy tuck. I a 34ddd bra now and would like to say this size but not need a bra and tanktops to make them look perky. I selected a 425 cc high profile implant.... how do i know if it will be too big? My surgeon states body type will handle an implant that big but im concerned im going to be too big?? Help.. suggestions welcome

Doctor Answers 18

What size implant should I get?

Size and shape of breasts can often play a critical role in a woman’s self-esteem. Fuller and bigger breasts are often associated with reproducibility therefore it is a desired condition. There are different kinds of breast augmentation operation types. Breast augmentation can be performed either with breast implants or autologous fat transfer. There are also different types of breast implants like teardrop or round implants. These implants also can be placed under or above the muscle. As you can imagine there are several different options for breast augmentation. The best way to understand which one is more suitable for you is to get a physical examination by a plastic surgeon.

What size would you like to be, an E?

Outcomes in breast implant surgery can only be improved when surgeons and patients are realistic about a patient's actual measurements, the type of breast tissue that you have and start thinking about long term outcomes. Your current size, a DDD, may or may not be accurate, but an oversized implant will add considerable weight to your breast and skin envelope and will NOT remain in place over the years. Breast augmentation surgeons who carefully measure, assess your skin quality, and type of breast parenchyma (tissues) should help you select an implant that will fit your tissues and be long lasting. For every 205cc of breast implant added, you will go up about one cup size at Victoria's Secret. For someone who has worked so hard to lose weight, are you sure you want to be an E or larger. What do you think you will look like in 2-3 years?

Caroline Glicksman, MD
Sea Girt Plastic Surgeon
4.6 out of 5 stars 10 reviews

That sounds like it may be too big

That sounds like it may be too big.   Based on your photographs, and the information that you have provided 425  cc implants may be too big  send me results with problems and undue stress on the incision lines from the breast lift. Also the larger they are  The more likely they will be to drop and bring down the breast again in the future.  If you want to remain your current breast size I would recommend using implants that are much smaller. 

Adam Hamawy, MD
Princeton Plastic Surgeon
4.7 out of 5 stars 42 reviews

What size implant .....

Thank you for the opportunity to discuss your goals and concerns.  I'm assuming your statement "breast reconstruction" means breast lift that would go along with augmentation.  The key facts here are that you want much improved shape and you want to stay about the same size.  From this information, the type of lift is very important.  With large, heavy, sagging breasts, a vertical lift would give much better shape and it would remove not just any breast tissue, but the lowest sagging breast tissue and thus be the most effective type of lift.  For my patients that want to stay about the same size, I recommend around 200 cc's.  Even with the 200 cc's, in removing breast tissue that would take away some of the increase in size all women end up being a little larger. I'm concerned that 425 cc's would make you considerably larger.  I would recommend a vertical type lift that would not only be very effective in improving shape but would take away some breast tissue to balance the enlargement from implants.  I would not use high profile implants necessarily but base the type of implant on your breast width.  Yes, your body type will handle an implant that size,  but I keep coming back to you not wanting to be larger.

Thomas Hubbard, MD, FACS
Virginia Beach Plastic Surgeon
4.9 out of 5 stars 32 reviews

Implant Size

The goal of mastopexy (breast lift) augmentation is to create an aesthetic breast with the size, shape, and projection that is desired by the patient. During a consultation, measurements of the breasts are used as a starting point to recommend a breast implant.      

The decision on size, shape, and position of these implants is based on your anatomy, the type and size of the implant, and your preferences. The type of lift is determined by your current nipple position and the quality of your tisssue.

Based on your photos and your bra size, you still have a decent amount of volume after your weight loss. Its not clear from your desciption if you are contemplating a breast lift and augmentation or a breast reduction and augmentation. If considering a lift, a small augmentation in the 200ml to 300ml range will help make the breasts more perky once they are lifted. In this setting, a larger implant would significantly increase the size of your breasts. 

See the link below for more info on breast augmentation and breast lifts.

A detailed examination will help delineate the best surgical treatment. In office sizing and digital three-dimensional simulations can help guide your implant choices. A second opinion with a plastic surgeon certified by the American Board of Plastic Surgery would be the next best step.

Breast Implant or uplift?

Firstly, congratulations on loosing all that weight, well done...! You seem to have good volume of your own breast tissue and you clearly say that you are happy with your current size. In that case, you do not need an implant and definitely not 425cc, you will probably end up twice as big with that volume of implants. 

You have ended up with excess lax skin as a result of loosing all that weight. All you need is an uplift that would involve tightening up the skin envelope, elevating the nipples and getting rid of the excess skin to make them perky again.

Breast augmentation, some advices:

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) and projection (the lift): Breast Augmentation w/Breast Lift.
I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection, and 400ml will be excelent on you, to fill the breasts properly.
Finally, to perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 147 reviews

Weight Loss, Breast Implants, and Breast Lift

Women who have lost 50 or more pounds have very stretchy skin in most cases.  Breasts often "deflate", with the nipples settling lower and often pointing down.  In situations like that, a breast lift is something that should be considered.  In the "ideal" breasts, the nipples are a little above the level of the inframammary crease (the bra line).  When the nipples fall far below that line, breast implants alone rarely (in my experience) provide a look that a woman likes.  Breast implants alone in those cases will usually result in one of two looks, neither of which is what most women want:  (1) the implant fills in the top of the breast but the nipples remain very low, giving the breast a "long" look; or (2) if placed on top of the muscle, the implants may settle very low, giving the dreaded "ball-in-a-sock" look, with no fullness at the top at all.  Either of these may look fine in a bra, but out of a bra it's a different story.   In my opinion, when someone takes the time off of work and away from the family to go through surgery, pays a lot of money for the surgery, and goes through the discomfort and anxiety of surgery, it's best to undergo the right operation, not just 'any' operation.  Women who have stretchy skin after weight loss are quite likely to have substantial stretching of the skin after adding the weight of an implant.  For weight loss patients, I find that a procedure that removes some of the stretchy skin, tightens the lower part of the breast, and repositions the nipples to a point at or a little above the crease level provides a better, longer lasting result than just undergoing an augmentation alone.

While no one viewing your photo on RealSelf can provide you with meaningful answers, a surgeon who does a lot of breast surgery should be able to help you make the choices that are most likely to lead to the outcome you desire.  If you like the way you look in a bra right now, may implants aren't needed at all.  Consider visiting with one or two additional surgeons.  Make sure you tell them exactly what you want, but also make sure to hear what they tell you.  Visiting with and selecting an experienced plastic surgeon with a great reputation is probably the best thing you can do to help you get the breasts you want!

Kelly R. Kunkel, MD
Fort Worth Plastic Surgeon
4.8 out of 5 stars 22 reviews

Breast lift without implants or vertical scar

You do not need implants. You have enough tissue to reshape and reposition them high on your chest. Implants alone will not help you. They will make you much larger than what you are seeking and stretch out your tissues where revisionary surgery will be needed. Breast implants cannot and do not lift breasts. All you need is a breast lift.  Please take a look at the video attached. This is a woman who wanted the same thing you do - just to have her breasts perky again. No implants were used and there is no vertical scar. 

 Best wishes and kind regards,

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.7 out of 5 stars 208 reviews

Lift vs implant

If you want your breast fuller and are happy with the shape of them, then an implant will be fine. Keep in mind an implant will only "fill our breast up" it will not "lift them up". They will look just like they do now, they are just bigger and fuller with an implant only. If you feel this will meet your goals, then an augmentation should be fine. If you are unhappy with the position of your breast and feel they are too low, then an implant will likely not satisfy you and you will want to consider the lift. A lift will "lift them up" and put them in a higher position, change the size of the areola and "lift" them off of your chest. Often times both of these procedures are combined to achieve an optimal result. By lifting them and adding volume, the breast will not only sit higher on your chest but will also have the nice fullness from the implant. In your case, you will be better off with both a lift and an implant.
Dr Scott Ennis

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