How to pick the right size or cc? I’m 5’8 and currently 150 pounds. Thinking about 580cc. (photos)

Question

In the beginning I like big breast. Now closer into picking the right cc I’m thinking my first decision of 580cc is way to big and might hav problems in the future. . I think now I want more of natural size like a celebrity. I’m 5’8, 150 and plus I’m losing 20 pounds before surgery in April. How do I pick the right size or the right cc. Also I want go over the muscle I like the look.

Daniel Barrett, MD · Answer

Hi divagirl92, 
  
Breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 
  
Implant profile is one of the important considerations to make. Many patients wrongly assume that the higher the profile the better. The truth is, the more profile (or projection/height) and implant has, the narrower its base has to become. This is associated with several problematic consequences. 
  
The first issue is that the patient loses width and therefore cleavage of the breast. The second is the breast becomes more narrow and pendulous, often falling lateral and onto the side of the chest, and third, high profile implants have a higher risk of bottoming out because they exert more pressure on the inframammary fold than moderate profile implants. 
  
High profile implants do have a role in symmastia repair (when I need to narrow the base width) but otherwise I try to avoid them.
  
When it comes to sizing, 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 it is 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, every one of them has 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.
  
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
  
Daniel Barrett, MD, MHA, MS
  
Certified, American Board of Plastic Surgery
  
Member, American Society of Plastic Surgery
  
Member, American Society of Aesthetic Plastic Surgery

Luis A. Mejia, MD · Answer

hello thank you for your question and provided inforamtion as well;..based in your question its difficulted evaulate your case with this angle of a picture, its recommended to get a consultation in personal with a plastic surgeon.

Daniel A. Medalie, MD · Answer

HI,I will be honest with you. 580 is much too big for someone your size. I don't know how much natural breast tissue you have, but in all events it is too much. I would recommend in the 375-425 range (but agin this depends on how much native tissue you have). Also I do not recommend going above the muscle. It looks good for a couple of years and then gravity relentlessly pulls the implants lower on your chest wall and stretches out the skin.You may get stretch marks and the implant will be palpable. I also don't recommend losing weight just for the surgery. Eat well, exercise and be healthy but don't make a special effort just for surgery, because if you don't maintain that lifestyle then the weight will come back. All of these choices need to be carefully discussed with a board certified plastic surgeon.Good luck.All my best,Daniel A. Medalie, MD

Kenneth Hughes, MD · Answer

The average volume in the US is 350 cc. So a 580 cc implant may be too large for you. The best way to determine what you would like would be to try on sizers in the office.   Choosing an implant based upon an aesthetic goal that exceeds your anatomic capacity may lead to complications and possible revision.   I think for those people in whom the living is made by athletic performance, the implant can be placed above the muscle.  Other patients will be happier long term with submuscular placement.My patients bring a few garments with them to the exam so that they can actually see how the sizers look under a tight sweater, bathing suit, blouse, work-out tops, and clothes they wear most often. I would recommend that you go with the size that boosts your self-esteem, and fits your anatomy.Consult with a board certified PS who can help you determine the best size for you. 
Kenneth Hughes, MD, ABPS Board Certified Plastic Surgeon
Los Angeles, CA

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 to obtaining a natural result is to stay within the parameters defined by your BWD. 
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

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. It would be helpful to view pictures of your breasts and know your individual breast measurements. 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. Best wishes and good luck.

Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Richard G. Reish, M.D.  FACS
 Harvard-trained plastic surgeon

Tom J. Pousti, MD · Answer

Thank you for the question.  Despite your good description of body type and goals, online consultants will not be able to provide you with specific enough advice to be truly helpful.  Ultimately, careful selection of plastic surgeon and careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging)  as well as careful measurements (dimensional planning) will be critical.
 
***Given your concerns, it is definitely worth spending more time (preferably prior to the date of surgery) with your plastic surgeon to discuss further.  One question that might be helpful to you: will you be more disappointed if you are slightly too small or slightly too big?  It will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.Make sure that you carefully consider the pros/cons associated with sub muscular versus sub glandular breast augmentation surgery.  I think it is in the best interests of most patients seeking breast augmentation surgery to have implants placed in the “dual plane” or sub muscular position.  This positioning allows for more complete coverage of the breast implants leading to generally more natural feel/look  of the implants in the long-term. This position will also decrease the potential for rippling and/or palpability  of the implants (which may increase with time, weight loss, and/or post-pregnancy changes). The submuscular positioning  also tends to interfere with mammography less so than breast implants in the sub glandular position. The incidence of breast implant encapsulation (capsular  contraction)  is also decreased with implants placed in the sub muscular position. 
On the other hand,  sub glandular breast implant positioning does not have the potential downside of “animation deformity” ( movement/ distortion of the breast implants  seen with flexion of the  pectoralis major muscle) that can be seen with breast implants placed in these sub muscular position.  Generally speaking, the best online advice I can give to ladies who are considering breast augmentation 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 the morning yes thank you work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining 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. For example, I have found that the use of words such as “natural” or "C or D cup" or "like a celebrity" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
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, after the use of temporary intraoperative sizers.
I hope this helps. Best wishes for an outcome that you will be very pleased with.

Atul Kesarwani, MD, FRCSC · Answer

A consultation with your Plastic Surgeon will help you decide on the right size for you.  The dimensions of your body and thickness of your present breast and fat coverage will determine the maximum diameter of implant that you should consider, than you can decide on how much projection you would ideally want and if your chest will accommodate it.Your surgeon should have sizers that you can try on for size and many practices may offer video simulation software to help you decide.A larger implant may have more possible long term complications.Good luck!

Mahmood Kara, MD - Account Suspended · Answer

Thank you for your inquiry. 
There
are many different factors that go into choosing a breast implant size which
will correspond with your body dimensions while concurrently achieving your
aesthetic results. Some of these factors are: Implant size (CC's), Implant
profile (Low, Moderate, High), Placement of the implant (Subglandular vs. Dual
Plane) etc. We utilize smooth round cohesive silicone gel 'gummy bear' implants
for the best results. 
During
a consultation your aesthetic goals are heard and taken into account with the
measurements of your breasts and the integrity of your tissue, as well as level
of ptosis (sag). From here we collectively can find your 'perfect fit'. 
You
are able to try out sizers and different implants in our office such that you
can get an idea of what size you would be post-operation. We also offer
Crisalix 3D plastic surgery virtual simulator during our
in-person and virtual consultations to preview potential results. After your
consultation, you will receive your very own implant sizers to take home with
you (at a small cost) whether or not you decide to go forward with your
procedure.
I
specialize in the 24-hour Recovery method which minimizes trauma to the breast
and decreases pain post-operatively.
We
encourage you to look at our website and Instagram (drkaraplasticsurgery) for
lots of before and after pictures!
Please
note that this response does not substitute patient-doctor relationship.
We
welcome any and all patients seeking advice to come in for
a complimentary consultation available for limited time
only.
During
the COVID-19, we are offering complimentary online consultations as well as
in-office consultation with social distancing and masks. Procedure done
in-hospital private surgical facility while taking covid-19 precautions. We
utilize UV-light to clean the air of viruses and bacteria during our
consultations and surgery.
We invite
you to come in to discuss your options more thoroughly.  Please
send us an email at info@drkaraplasticsurgery.com with the subject line:
"Attention Meagan" and we will be happy to
coordinate your appointment!
M.Kara,MD,FRCSC
(27+ years experience)
-
Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital
private surgical facility for your added safety and peace of mind

How to pick the right size or cc? I’m 5’8 and currently 150 pounds. Thinking about 580cc. (photos)

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