5’0 115lbs starting at 32C, can I get a second opinion on picking the best implant size? (Photos)

I recommend consultation with a plastic surgeon to be measured and discuss your goals. 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. You should also be aware that results of surgery can change in the future with significant weight change and/or stretching of skin from the milk of pregnancy. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame

Good evening!
Conventional wisdom says always choose the larger of the two sizes you are considering- almost no one comes back and says their implants are too large!

There is not a lot of difference between the 400cc, 415cc, and 450cc in overall result.
Breast implant size has nothing to do with bra cup size - which varies with each bra manufacturer as you noted. The average implant volume placed in the US is 350 cc. A very general estimate is that one cup size is 150 to 200 cc of volume, but realize that no direct correlation exists between the two.
None of the modalities to approximate final results from breast implants are 100% accurate; they merely facilitate the patient and the board certified PS concurring on the size and type of breast implant which will come the closest to reaching the patient's goal. My patients prefer to try on sizers under garments they typically wear (as you did) to determine if they fit as expected and help allay some of their trepidation associated with this decision.
I would recommend that you go with the size that boosts your self-esteem, and fits your anatomy.

Thank you for your question and photographs. I think you are starting from an excellent position and should anticipate a nice result. Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would continue to work with your plastic surgeon to ensure that the implants you decide upon are the right ones to meet your expectations. The sizing your are listing would leave you with a large overall breast size so try on the sizers again to get a visual representation again. Best wishes

Dear aruss008,
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

I would suggest going back to your surgeon and trying on sizes again. With your own breast tissue, I think the smaller size will look very nice and not be too big.

The difference between a 415 and a 450cc is so small that people will not notice the difference unless you tell them. I always recommend going with the larger of two implants that you like because you will have some tissue thinning with implant placement and your implants will appear slightly smaller once you are healed. I have never had a patient regret going with the slightly bigger implant, but I definitely get patients who regret going with the smaller implant. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon​

The best cosmetic result in any particular breast augmentation patient depends on a variety of factors, including: Your individual anatomy, desired outcome, realistic expectations, a thorough discussion with the plastic surgeon about the options, and an understanding of the pros and cons of any particular implant choice. Proper sizing is not just about the number of cc’s. or the type of implant. The thickness of your tissue, breast dimensions which include the width, height, and projection, as well as chest wall width all need to be considered when choosing an implant. Trying on implant “sizers” of various shapes and volumes while wearing a tight t-shirt, bra, or bathing suit at a preoperative visit will help you and your surgeon choose the optimal implant.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest that your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Dear Ms. Aruss008,

Thank you for your questions.

Nothing substitutes for a personal evaluation, a review of your medical history/medications, examination of your chest wall/breasts, measurements of your breasts and a face to face discussion of your options.

Unfortunately with out a exam of your tissues I can can only comment based your story and photos. . However, hope you find my following comments helpful.

There are many other factors to consider besides just breast implant size. These include, but not limited to your final desired breast appearance, shape, profile of the implant, implant filler material access incisions, implant location (under/above the muscle) and implant positioning on the cihest are personal choices made together and guided by the experience of your Plastic Surgeon. Your SPECFIC breast anatomy will dictate some of your choices.


As far as cup size (actual volume of the breast) most women have come to realize that there is a significant variation between bra manufactures and all bras are not equal in "cup size" equivalents.
Thus “cup size" is a very crude and non standardized measurement and varies by bra manufacturers. The actual strap and cup size you eventual are measured for is not as important as your final body proportions, shape and overall appearance. I believe it is most important to create the breast that the patient desires and then find the bra that best fits then vice versa.

In addition I have found it quite helpful if prospective patients bring at least 3 nude model goal photos depicting what their desired breast shape is. This will help determine the final positioning of the breast implant on the chest wall.

I not found computer generated automations as helpful as the “”tried and true” use of specially designed breast sizers (not Implants) or the use “rice in a nylon” which can give you real time and a actual 3-D visualization.

1)sizing:
A)Realizing there are no standard bra (strap/cup) sizes, purchase several bras (full bodied and no padding) of the strap and cup size you think you want to be.
B)take a measuring cup (1 oz=30cc) place rice in a nylon. Therefore 13 and 1/3 oz. = 400cc.
C) try on various volumes of rice with some form fitting clothes.
D)if implant is placed under the pectoralis muscle I usually add 10% volume to what the patient chooses.... To compensate for the muscle pressing down on the muscle and for the naturally settleing of the implant which often makes the breast appear smaller 2-3 months after surgery.
E)most women are NOT perfectly symmetrical either in volume, shape and nipple/areolar position. Usually differential sized implants can be used if there is a significant breast volume discrepancy (usually greater than 50-75 cc difference in volumes). Intra operative maneuvers can be used to improve nipple areolar and breast symmetry. If needed after the breasts have “seated” (final position) and if desired the nipple/areolar position can be adjusted under local anesthesia as a minor surgery in the office.
E) CAUTION: it is difficult to extrapolate from limited photos of other breast augmentation photos and volume of implant listed to your expected and final appearance. Thus the reason for a personal consultation, examination of chest wall/breasts, measurements and discussion of your particular desires.

2) profile of implant:
A) for the same volume the higher the profile the narrower the base width.
B)there is very little difference in projection between a moderate to high profile implant, thus little affect on how the actual breast and nipple project
C) in my opinion the base width of the breast should equal the base width of the implant to eventually obtain maximum cleavage and prevent lateral (increased side) breast volume. Thus I personally chose the profile based on the patients chest measurements, (a high profile on a wide chest may not result in the cleavage desired and conversely a low profile on a narrow chest may result in implant in the outside arm area).
D)There are 3 companies that produce silicone gel filled and four companies that produce saline filled implants. Each with a slight variation of base width to projection (profile of the implant).
Most plastic surgeons have access to all companies.
Allergan Company has the greatest variety of implant profiles (base widths to volume).
E) Cleavage is largely determined by your anatomy. This can be optimized by choosing the best profile implant and postoperative implant displacement excercises towards the midline of your chest.

3)Shape of the implant:
A) for the vast majority of cosmetic patients I recommend what are referred to as “round” implants
(which refers to their base) but are actually elliptical in shape.
B) for reconstructive patients shaped/form stable implants are often used because of acquired lack of breast tissue.

4)Placement of Implant
A)decision of implant(subpectoral, dual plane, or suprapectoral) will be determined based on your anatomy and long term goals and benefits. Placement under the muscle and dual plane are associated with the lower chances of capsular contracture.
B) Location of the implant on the chest wall will depending on your specific goals ie upper pole fullness (high and “fakery”), neutral (full slope) or
lower pole fullness.

6)Filler Material
A) silicone gel feels more like breast tissue, less potential rippling, comes prefilled cannot adjust size intraoperatively and larger incisions to place compared to equal sized (non prefilled) normal saline implants.
B) normal saline implants can be adjusted in size intraoperatively, if ruptures normal saline absorbs, potential increase rippling compared to silicone gel, smaller incision to place normal saline implants as compared to prefilled silicone gel implants.

In summary:
I suggest you collect several nude model photos of the goal breast shape you desire and schedule several additional consultative appointments with experienced Plastic Surgeons or if you have chosen a Plastic Surgeon please make sure he/she is Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).

My best wishes,

R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
Awardee: RealSelf 100
Member: RealSelf Hall of Fame
wwwimagineplasticsurgery.com
4646 Brockton Ave
Riverside, Ca 92506
(951) 686-7600

Thank you for the question and photos and size is an individual decision based on measurements and putting implants in a bra till you see the volume on your chest that you like. So if you have concerns go resize till you the the volume that you like.

Dr Corbin