Which would you recommend; 385cc srf vs 375cc HP? (photos)

Question

I am 12.5 bwd and when I told my doctor I wanted to go bigger than the initial size (305cc mod) he suggested either natrelle 385cc srf or 375cc HP. Is that took big? I still want a natural look. Actually I want to have large natural looking breast even though I know their implants. Will the implant sit up too high? Im 5'4 115lbs... I love the look, but a few of my friends kept telling me they're too big or too small.

Steven J. Rottman, MD, FACS · Answer

Thank you for the question and photographs. "Tissue based planning" relying on your chest and breast measurements is the safest way to ensure good long term results. Your surgeon most likely determined what size and projection are necessary to give you your desired result based on your body's measurements. Choosing an implant too wide or too large will lead to problems in the future which will require additional surgery. 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 breast surgery. Hope this helps and good luck with your surgery.

Jed H. Horowitz, MD, FACS · Answer

In general, if a woman wears a size 36 AB bra and would like to be a C cup, which is the average size that women wear and the average size bra that is sold, she needs a volume of approximately 350 to 390 cc to make that change. This becomes less if she's wearing a 34 bra, because it has a smaller strap size and the cups have a smaller diameter. A smaller diameter implant would then be a volume of approximately 300 to 350 cc. In the same way if she was more petite, maybe a double zero or size one and wore a 32 AB bra, then to become a 32C cup she would only require about 250 to 300 cc. This is a general number, and of course there are other factors that will affect this. Other factors which contribute to the outcome are size, shape, and profile. The #profile is determined by the amount of #projection versus roundness that the you desire, as well as the #size of the implant and size of your chest. Also, the placement or incision location will also have an effect on profile. Many women tend to choose silicone breast implants due to the natural feel and appearance. Silicone implants are now made of a cohesive gel which are anti-leak even when cut.  Often times a woman has breasts which vary slightly in size. If one breast is slightly smaller than the other, each implant can be filled to a different amount to create better symmetry.  Saline tends to be a little less natural feeling than silicone, but it can also create a more dramatic upper breast appearance, which some women prefer. The Ideal Implant™ was created for women who are not comfortable having silicone implants in their body, but desire a more natural feeling implant than traditional saline implants on the market.  The unique structure of the Ideal Implant allows for a similar look and feel as silicone with the safety of saline.Another element to a satisfying result of your #augmentation is realistic #expectations.Talk to your surgeon at greater length and be sure to view before and after pictures and reviews beforehand to gain more reassurance of the procedure.

Nelson Castillo, MD · Answer

Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. 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. I would recommend you voice your concerns with your surgeon, they are in the best position to ensure that the implants the two of your decide upon are the right ones to meet your expectations. 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. Based on your goals I would preferentially recommend the SRF as they lead to a less subtle, less natural result, with greater upper pole fullness. I would caution you on the size, as you do not have a large skin envelope and have a short distance from your nipple to breast crease which requires a smaller implant to help stretch out the skin and appear more natural.  Best wishes!

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

Director-Beverly
Hills Breast and Body Institute

#RealSelf100Surgeon

Adam J. Oppenheimer, MD, FACS · Answer

I like the SRF implants compared to HP. The higher fill ratio contributes to a rounder look that's less resistant to being flattened by the muscle.Those implants might be a tad big for you. Your nipple to fold distance is short, and you'll have to lower your fold to make room for them. It may stretch out your skin and lead to stretch marks. Your nipples will widen. Your left fold is higher than your right and this will also need to be adjusted by your surgeon to create symmetry. You might even benefit from a larger implant in that smaller breast. The simulation doesn't quite look fair based on your starting point. Perhaps it's idealized a bit, for example, your left nipple is higher, but they look perfectly even in the Sim. I'm all for crisalix, but only when it's used realistically. Plus i'm pretty conservative when it comes to implant size... e.g. i'd be on the 305 side and not the 385 side for you. Ignore your friends, btw. go with your gut.

Robert Singer, MD · Answer

The interpretation of
"natural looking" varies greatly from patient to patient and from
surgeon to surgeon. The best cosmetic result in any particular breast
augmentation patient depends on a variety of factors, including: your
individual anatomy, realistic expectations, a thorough discussion with the
plastic surgeon about the options, and an understanding of the pros and cons of
any particular implant choice. Proper sizing is not just about the number of
cc’s. The thickness of your tissue, breast dimensions which include the width,
height, and projection, as well as chest wall width all need to be considered
when choosing an implant. Trying on implant “sizers” of various shapes and
volumes while wearing a tight t-shirt, bra, or bathing sit at a preoperative
visit will help you and your surgeon choose the optimal implant.
There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 32 C-D and a 38 C-D are significantly different. Cup size varies from
manufacturer to manufacturer and even within styles from any particular
manufacturer.
Keep in mind that following the advice from a surgeon on this or any other
website who proposes to tell you exactly what to do without examining you,
physically feeling the tissue, assessing your desired outcome, taking a full
medical history, and discussing the pros and cons of each operative procedure
would not be in your best interest. I would suggest you find a plastic surgeon
certified by the American Board of Plastic Surgery and ideally a member of the
American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are
comfortable with. You should discuss your concerns with that surgeon in
person. 
Robert Singer, MD FACS
La Jolla, California

Darryl J. Blinski, MD · Answer

Besides choosing volume and shape of implant, you will need/require different sizes because of your moderate asymmetry!

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your photograph, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. You have also done a nice job, both in your description and with your goal photograph, communicating your goals here.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.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 words such as “large 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 for petite patients) helps. Best wishes for an outcome that you will be very pleased with.

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