What Projection/cc Gel Silicone So Not Too Large or Too Narrow for Natural Look? What Questions to Ask?

5'6" 115lbs 12cm bwd small A. I want a natural look in a full B-to me that means they are not obvious implants& have a natural slope at top. I have a "nice fold" on each, but the tops have atrophy due to kids.My PS has rec HP250-375 submuscular. 325 is the largest I can imagine after trying them on, but I'm worried its too big. The RN said 300 looked too narrow& would probably not look natural. What projection/cc would u recommend. what Q's should I ask to ensure I get the right implants for me?

Doctor Answers 3

Communicating Goals prior to Breast Augmentation Surgery?

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Thank you for the question.  Although I cannot provide you with a “list” of questions that you should ask your plastic surgeon, I would agree with you that careful communication preoperatively is one of the “keys” to achieving your goals with breast augmentation surgery.

As you communicate these goals I would suggest that you not use cup sizes as a reference.  As you know, cup  sizes can vary from one bra manufacturer to another;  therefore communicating with the use of cup size terms can be a potential source of miscommunication/dissatisfaction.

I would also suggest that you do some homework and begin finding pictures of breasts that you like ( as well as pictures that you feel are too small or too big). Doing so will allow you to take these pictures with you to your consultation and helps with the communication process. Show your plastic surgeon what you mean by “too large” or “too narrow”. Pictures are helpful because these terms can mean different things to different people; therefore can be a source of miscommunication.
Again  given that preoperative communication will be key,  I would suggest as much time as possible spent with your plastic surgeon as opposed to the R.N. 

Best wishes.

Implant size selection to achieve your goals

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I consider two factors when selecting implants for my patients:

1.Dimensional planning
2.Gel Implant Sizing system

Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.

Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.  If you have decided on saline implants, then based on the gel sizer you select, we can guide you to the saline implant that achieves a similar look.
Hope this helps.
Dr. Basu
Houston, TX

What Projection/cc Gel Silicone So Not Too Large or Too Narrow for Natural Look?

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Thanks for your question. Implant size and contour are hard enough decisions to make based on in person consultations. It is impossible to give much in the way of usable advice without at least photos. 

That noted, I am pleased that you have had the opportunity to try on sizers. I find the sizers look a bit larger on the breast that the same size placed surgically, by about 5-10% (though this is not an exact science). So if a patient likes the look of a 300 cc sizer, I would use a 325 cc gel implant (if high profile).

Given your experience with sizing, and your breast width, I would be thinking about a 304 cc moderate plus (Allergan) or a 325 cc HP. 

Last comment--as a rule, patients who are a bit smaller than they might have wished are still usually pleased. Patients who are larger than they wished are not.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.