Breast Implant Research

I'm a 5'6" 132lb C and have done some research and think I want between 500 and 650 cc silicone hp implant. Probably under the muscle. Is this reasonable or is there a high risk of problems? Will I be able to run much or at all if I use two sports bras? I want silicone because I want them to still move but am afraid that size might mean they will be harder. My friends that have saline are too hard so I don't want that. If this is a bad idea what size would be better?

Doctor Answers 11

Sizers and dimensional breast augmentation

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It's better to see your surgeon for a sizing session rather than guess at what you'd like. I use a technique called dimensional breast augmentation which involves taking in a number of factors and measurements. You can also try on sizers.

Breast implant size/cup size?

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The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 
Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.

2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.

3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.

4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

Misunderstandings about hardening breasts with implants.

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Implants generally don't get hard however the capsules which form around the implants can get hard. To give an oversimplified analogy, it is like jeans that shrink around your thighs and make them feel hard. A consultation and measurements can help you choose size and profile.  Going under the muscle is a better chioce, especially if you are a runner. 

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

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Research on sizing

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Thanks to the internet, anyone can research just about anything without leaving home.  This can be good and bad.  Anyone can post information as "facts".  That being said, your best research can be done with an experienced board certified plastic surgeon.  He will examine you, take measurements and recommend sizes that are appropriate for your situation.  I like to have my patients try on the different sizes during the consultation.  That will assist you in finding the size that best fits the size and shape you have in mind. 

Implant sizes

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not one size fits all - it really depends on your frame, and build  

Generally speaking, larger implants in that range have more long term complications such as shifting or malposition.

David A. Lickstein, MD
Palm Beach Gardens Plastic Surgeon
5.0 out of 5 stars 9 reviews

Implant choices

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To determine the exact size for you, a full exam is in order. Without that I could not be sure how your body would respond to that size implant.  Remember the bigger you go, the potential more problems done the road.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast Implant Research

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You failed in your research! Best to see in person a boarded plastic surgeon to discuss "your research". From  MIAMI Dr. Darryl J. Blinski

Breast implant sizing is important

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I'm going to go out on a limb here and say that 'running' with 650 cc implant might be a bit uncomfortable.

You live in LA, and the 'look' down south is different than in my community- but think about the long-term issues with large implants (of either type)- you will likely experience implant rippling, capsular contracture, malposition, implant and breast sagging and re-operation at a higher rate than someone who had a more reasonably sized implant placed.

Don't try to choose your own breast implant size

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As you have no training in plastic surgery, it is total guess work what you are doing. The proper size is based on careful measurement of your frame, an analysis of your own tissue and potential drooping, and analyzing what implant will give the look you want.  Larger implants are prone to more problems but you need to take these risks on if only this size will make you happy.

Large Implants Lead to Fake Look & More Potential Problems

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The implants you mention (500-650cc) are very large for someone who is a C-cup pre-op.  I think you will definitely wind up with a "fake look" and will also increase your chances of implant displacement, "bootoming out", and capsular contracture which is the cause of the hardening you seek to avoid.

John Whitt, MD (retired)
Louisville Plastic Surgeon

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.