Which Would You Reccommend 475 Cc Gel Implant or 500 Cc Gel Implant Help?

Question

I am scheduled for breast augmentation on November 14th 2013. I am 24 years old, I will be 25 by the time I have surgery I am 5"7 and 125 pounds. I am pretty petite and I was originally going to go with 425cc gel implants high profile under the muscle but after going back for a second consultation and trying on the 500cc gel implants I have decided I like the look of that better they too would be under the muscle high profile, im wondering what size this will bring me up to as I currently am A-34 and I want to be a very large C cup! and given my measurements which would be a better fit for my body type and height. Please help ???

Trevor M. Born, MD · Answer

Dear prettyB

	Thank you for your question!  Breast implant sizing is the most challenging part of the decision process in elective Breast Augmentation.  The larger the implant- the more you will see implant shape instead of your breast shape.  The larger the implant - the more changes to your breast tissue- and possibly more rippling being visible.  Ideally the width implant  should be within the width of your own breast.  High profile implants are better for individuals with more breast tissue. That being said- the difference in implants that you are considering is 5%- which will be very difficult to discern any difference after your surgery.

	With Warm Regards,

	Trevor M Born MD

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 425 cc implant to make her go from a “A” cup to a “C+” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below.

Gary M. Horndeski, MD · Answer

I would not recommend either 475 cc or 500 cc.  If you are 34 A each 100 cc’s of implant corresponds to 1 cup size change.  To achieve a C you would require 200 cc implants.  Since you describe yourself as petite, I doubt 475 cc or 500 cc implants would fit in the retro-pectoral position.  The implants would extrude inferiorly and laterally requiring revision.  Unfortunately, you have not provided any photographs but it is possible that you may benefit from a simultaneous lift if you have breast ptosis.  

	 

	Best Wishes,

	 

	Gary Horndeski, M.D.

Michael Kreidstein, MD, FRCS(C) · Answer

Thank you for opportunity to answer this question. We get asked this very same question by many of our patients, and often by email at 3 am on the night before surgery! There are many important decisions that contribute to a beautiful result from surgery, but patient angst seems to focus on size (and often tiny increments) because size is the one parameter for which they feel qualified to contradict a surgeon's advice. A 5% change (25 cc) makes no difference, and I think in general a change in size is visible only if at least 10% (50 ccs in this case). You should go to your consultation and ask to see the very biggest implant that can safely be used for you (given your chest width, soft tissue characteristics, etc.), and then work backwards from there to choose a good size with your surgeon. And remember, there is no perfect size- a size that is perfect in a bikini is not as perfect when you are out for a run getting in shape for a bikini.

Paul Gill, MD · Answer

This is a very small difference in volume.  You have done the majority of your homework by narrowing down your selection to this range.  I would let your surgeon determine the best size for you in surgery.

	In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.
	Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
	The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
	I wish you a safe recovery and fantastic result.
	Dr. Gill

Jeffrey Zwiren, MD · Answer

There are many factors that go into selecting a breast implant other than just volume. If the base diameter and projection is not correct then the volume will not matter. There is an objective range for all patients and if you stay with this objective range you will have an implant that will be in proportion with the rest of your body and will not cause secondary problems such as stretch deformities. Your plastic surgeon is in the best position to determine if you are picking an implant that is too wide for your breast base diameter.

Sugene Kim, MD, FACS · Answer

There is not much difference between 475 and 500cc implants.  There are several variables in determining implant size.  When recommending implant size for my patients, I consider the followings: 1) patients' anatomy (height, weight, chest width, chest height, amount of breast tissue) and 2) patients' desired look/goal.  Without knowing your chest measurement and breast tissue amount, I cannot give you any recommendation.  You should visit with board-certified plastic surgeon who will examine you.  Try implant sizers to get a rough estimate of the size you may want.  As you know, bra/cup size will vary depending on the brand.  Good luck with you.
	Dr. Sugene Kim

Mahmood Kara, MD - Account Suspended · Answer

Hello. Thank you for your inquiry. It is important to have an in-person assessment regarding your concerns as it is difficult to determine virtually.

Exact end results and cup sizes are usually quite difficult to calculate as everyone has a different starting point.

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 usually recommend that my patients stop smoking, take vitamin C daily, and avoid aspirin/ibuprofen and vitamin E 3 weeks prior to surgery. 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
Hello. Thank you for your inquiry and congratulations on your surgery! It is important to have an in-person medical assessment regarding this issue as it is difficult to determine virtually. Continue to update your doctor in the matter and follow their post-op protocol.

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

Val Lambros, MD, FACS (retired) · Answer

A 25 cc difference in implants this size is basically not visible. It is less than two tablespoons . If you want to be as big as you can go for the 500. It is more of a psychological issue. 

	 

	VL

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