What's the difference between 405cc and 445cc mod plus natrelle round, smooth implants? (Photo)

Question

Getting a BA in a week, and I am sacred the 445 is too big . I can't make up my mind . I want a d cup and not a lot larger . I'm 5'2 130lbs and a deflated 34a .

Jose M. Soler-Baillo, MD, MS · Answer

Thank you for your question and photos.  The difference in size between the two implants is not significant.  If you are torn as to which would be best for you, ask to "try on" the implants in your surgeon's office.  Also, try to focus more on the look than size as it is nearly impossible to predict cup size prior to surgery.All the best,Dr. ResultsMiami, FL

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

Sheila S. Nazarian, MD · Answer

I would suggest that you "try out" both the 405 and 445cc and see which "look" you like best. Never a good idea to focus on cup size as they fluctuate so much between bra manufacturers and can be deceptive. Best, Dr. Nazarian

Curtis Wong, MD · Answer

in your unlined bra, you will do fine with the 445 cc implant.  Size and understand that whatever is in your bra should be increased by some small amount to create that look... I use 10% in my practice and my patients have been delighted with their outcomes.  Whenever two adjacent sizes are desired, my recommendation to my patients is to always go with the larger one and I've never been wrong in my career so far.

Tom J. Pousti, MD · Answer

Thank you for the question.  Ultimately, 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 that your surgery is coming up soon, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.

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 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 know words such as “natural” 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 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 (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Steven M. Camp, MD · Answer

Thanks for your question and pictures.  I would recommend the combination of trying on different sizes and if possible utilizing the Vectra Imaging device that many plastic surgeons have in their offices.  Some general advice I give patients regarding breast surgery:1. Select a board certified plastic surgeon that you can communicate with comfortably to establish your desired look.2. Establish that your plastic surgeon has your best interest in mind and make sure that they can explain your procedure to you in a way that makes sense and makes you comfortable. I want my patients to walk out of my consults and feel like they “get it” with respect to their surgical plan. I want to make sure that my patients can understand what a specific implant may deliver in regard to their results. This is common when we are trying to determine the size a patient desires, and also whether or not to select a shaped highly cohesive implant compared to a round silicone gel or saline implant.3. Make sure that you understand what to expect in terms of your recovery and postoperative instructions. In my practice I give my patients additional instructions and tools to help them recover. In addition, I follow all of my patients closely after surgery and visit with them at 1 week and 3 weeks after surgery to make sure they are healing as expected.

Ravi Somayazula, DO · Answer

Approximately 150 cc to 200 cc is one increase in cup size, therefore on average an implant that is 40 cc will be approximately be 1/3 of an increase. This is a general rule of thumb. The difference of 40 cc can become more obvious the smaller you are to begin with. If your starting cup size is an A, the extra 40 cc will certainly make a difference as far as look and size is concerned. My suggestion is to try on sizers of the 445 cc and the 405 cc and see for yourself if that difference is too big for you in the mirror. Your specific breast measurements and tissue characteristics will determine if a 445 cc implant will be appropriate for you. In summary, if you like the 445 cc sizers in the mirror and your measurements and tissue characteristics can accommodate the increased volume then I highly recommend choosing the 445cc implant. Most women who are not as happy with their results after breast augmentation fall into the category of wishing they had "gone bigger". Hope this helps. Thank you for your question. Good luck.regards,Dr. Ravi Somayazula

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the photos and the question and size is an individual decision based on measurements and putting implants in a bra till you see the volume on your chest that you like.  That said 40cc's is not a lot of difference so which would you rather be a little bigger or a little smallerDr. Corbin

Ronald V. DeMars, MD (Retired) · Answer

The difference is a little less than 3 tablespoons. If you're worried, the obvious answer would be to go with the lower volume. Unfortunately clothed photos are of no help to us. Nor have any of us examined you for volume and quality of breast tissue or chest dimensions. Only the surgeon who has examined you can give advice that has any value.

M. Dean Vistnes, MD - Account Suspended · Answer

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 SurgerySan Francisco Bay Area#drdeanvistnes #breastaugmentation

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