Question about implant size: 375cc vs 400 cc? Are the sizes seen with sizers accurate? (Photos)

Question

I’m feeling unsure about which implant size to choose, and I’m a bit afraid of it looking too exaggerated. I’ve always wanted bigger breasts, so I do want a larger implant. I’m deciding between 375 cc and 400 cc silicone implants. My height is 5’0” and I weigh about 88 lbs. I already tried the surgical bra with the sizers, but I’m still unsure if the size I see with the sizer will change after surgery. Does the breast usually look bigger, smaller, or about the same as what I see with the sizer during the procedure? Thank you!

Daniel Barrett, MD · Answer

Dear Brave976094,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Leila Kasrai, MD, FRCSC · Answer

Sizers are a fairly good way to see how you may look after surgery. There may be a bit more compression of the implant, but you’ll still be able to get a great visualization of your predicted results.

Brian K. Reedy, MD · Answer

Thanks for your question! 400cc on an 88lb/5'0" frame is a lot of breast. I would encourage you to err on the side of caution and go with the smaller. The implants will look a bit smaller once they are actually in your body. Good luck!

Luis A. Mejia, MD · Answer

Dear Brave976094, thanks for sharing your concerns, implants sizes selection are maybe the difficult step in this process, I do suggest to take a sit with your surgeon and talk about it, discuss your desires and listen his or her recommendation about, to meet your expectations. However it is impossible to pick or recommend style, shape or sizes without an in person consultation, that provide the chance to get the measurement of key breast parameters. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia

Donovan Rosas, MD · Answer

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and your surgeon create your custom surgical plan. 
With regards to your specific question, given your measurements, your implant choices sound large. None of the available sizing options are 100% accurate. But they are useful tools. Volume is not necessarily different post op but shape and projection will change (leading to the tendency to go bigger). 
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs or told us your bra size. At size 32 or 34, each 100 cc of implant corresponds to 1 cup size change. At size 36 or 38, each 200 cc of implant corresponds to 1 cup size change. From this, you can compute volume required to achieve your desired goal. 400 cc implants weigh 400 gram, will result in descent and will be very heavy. I recommend smaller implants to be more stable long term.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Adam Tattelbaum, MD · Answer

Thanks for your question,

In my own practice I have found that looking at actual implants in a bra on your body is the best way to judge. I don't think virtual images are nearly as accurate as looking at yourself in front of a full length mirror. Implants tend to look smaller once inside you,but they are not. At your height and weight you run the risk of looking unnnatural if you go too big. I hope the link below will be helpful as well.

Best wishes

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Camille Cash, MD · Answer

The difference between the two implants you are considering is only 25cc.  This small difference will not be obvious with the naked eye once the implants are placed.  Sizers are to help you get an idea of how you'll look after surgery.  They cannot exactly duplicate it.  I like to use implant sizers during surgery to help me choose the implant that best matches my patient's desired look.  I've included a video I hope you find helpful.

Question about implant size: 375cc vs 400 cc? Are the sizes seen with sizers accurate? (Photos)

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