Should I go with 550cc or 600cc high profile silicone? I want to option of wearing a bra or not. (photos)

Question

I am getting a breast augmentation on January 13. I've had my consultation with my PS and tried on sizers. My goal look is big breasts for my body, but not way too big for my body. The fake look is fine by me and I want the option of wearing a bra or not. I can't decide if 550cc or 600cc will be the right fit! My PS stated I do not need a lift to achieve this. I'm 5'7 and 135lbs, have 2 kids and breastfed both. I had larger breasts, but between weight loss and children they have disappeared.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question

Im assuming your asking about increasing our size or not. Overall, your breasts a[[ear to be perfectly normal (natural) if the size is bothering you then please read on.

After performing hundreds of breast augmentations, I have found that 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 softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured.

Anatomic gummy bear implants might be a good choice to give you a more natural look. 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. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.

We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.

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

#RealSelf100Surgeon

#RealSelfCORESurgeon

Scott C. Sattler, MD, FACS · Answer

You should expect a very nice result with breast augmentation surgery. To get the full and round look that you are interested in, implant sizing and measurement of your chest dimensions will be critically important. We are happy to see you in our Seattle clinic.

Austin Hayes, MD · Answer

Thank you for your question. It's important to know that with large implants, not wearing a bra will call your breast to sag and stretch more quickly. The implants will be heavy, and you will notice the weight. Regarding sizing, only an in person consultation will be of any real help. Discuss this question with your surgeon, for best advice.

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. If your goal is an augmented and large look, then I would say go for the larger implant and you will likely not regret choosing the larger size. The only thing to be careful is to make sure that the width of your chosen implant is not too wide for your natural breast width. If the 600 cc implant fits in your base width, then I think you will be happiest with that choice. Best of luck!

Curtis Wong, MD · Answer

Whatever sizer it was that you liked, and assuming you used an unlined bra, increase that by 10% and you will get something close to what you saw.  Taller women can handle larger implants but your chest and breast dimensions also have a very important role in determining what size will fit on you.

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 words such as “fake look” 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.

Ronald V. DeMars, MD (Retired) · Answer

Thanks for your question. Unfortunately the surgeons on this site will all tell you pretty much the same thing....we can give you a few ideas regarding surgery if we have good photos but no one can tell you what implant size, style and shape is best for your anatomy to meet your ultimate goal without a consultation and exam. I assume you understand trying on sizers is at best a poor estimate of what your results will be. Implants ON you look very little like implants IN you. At the size you mention there will be about 1.5 pounds of weight added to each breast. Going without a bra for other than a few hours would be unwise if you want to maintain a youthful look. Best of luck.

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