I'd like 475 and 500cc implants, but don't want to be too round. Is this the right choice? (Photo)

Question

I am 22, 5'3 and 117 pounds. Sometimes down to 110. So anyways i have a bwd of 13.5 going with silicone gel mentor brand. I had 2 kids. When engorged with milk i was a 34d. My doctor said 425 mod+ was the biggest he could do then i asked about 475/500 in hp since they are same diameter he said hed do whatever i pick the vectra3d looked great he said itd give more roundness on top than it showed. Some fake is okay im small going big so itll be somewhat fake but i dont want circle boobs nor saggy.

Donald Groves, MD · Answer

Hello and thank you for your question. Honestly, a formal in-person evaluation would be needed to determine the best treatment. There are several reasons for this: 
1) Bra sizes vary based on the clothing store (for example, Victoria's Secret tends to upsize everyone by a whole cup size)
2) Most women do not wear the proper exact fitting bra size for their bodies
3) The exact volume (in cc) needed to change cup size is different for different body types (e.g. 32A to 32D requires a different implant size than 38A to 38D)
4) Be careful NOT to fall into the trap most women do- they see a certain implant size (e.g. 285 cc) or perhaps their friend had a certain size, and they want or request this or another size based on that. Everyone's body is different- 285 cc implants on your friend might look VERY different than they would on you. Be very careful not to make this mistake, because the goal is to find the right size and shape for YOU- for your particular body and your breasts.

Because of those multiple factors, and because it is KEY to fully evaluate your breasts in person to make a full set of precise measurements to select the proper implant for you (incorporating factors like amount of breast tissue, implant type, base width, projection, etc), answering your question really would need a formal personalized consultation- to say anything before that would simply be guessing, which would be both unfair and unhelpful to you. Also, just FYI, each surgeon's measurements are slightly different, so numbers, experience, and overall aesthetic from one surgeon aren't necessarily the same as those from another surgeon!

Your breasts are such a KEY area of your body and your femininity- therefore, you should ONLY trust an experienced aesthetic plastic surgeon. As such an expert, I have had extensive training and experience with complex aesthetic surgeries under a multiple world-renowned experts in the field. I’d recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with aesthetic plastic surgery procedures) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case.

I'm located right here in California. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Joe Gryskiewicz, MD, FACS · Answer

Hi Mrs. Kay,We love the Mentor HP implants because they have a narrow diameter and still deliver a good deal of volume. Here are a few tips for you because this is perhaps
the hardest decision for a patient to make, as well as the surgeon.  Also see the video attached to my answer.  We spend up to two hours for our BA consults
to be sure there is careful communication. We do a full exam in front of a
full-length mirror taking six exact measurements.  We put your photos on a large computer screen
for imaging, and go over your “ideal-size” photos. We then save this
information to your password protected “web account.”

First and
foremost the implant should fit the dimensions of your breast and tissue cover.
 Balancing the implant to your
over-all body shape and tissue cover is essential.The main thing is to have the diameter of the implant fit the diameter of
your breast "foot print".  The average size
chosen over our last 7,000 breast implants was “350cc”.  BUT, 90% of our patients tell us they wish they were bigger a year after
BA.  (We will see you every year for
routine checks at no charge.) It’s like your mind incorporates the "new
you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
 You can try on implants in the office by
placing them into a special bra.  The implant is also flattened somewhat when under
the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket.  Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues.  Multiple measurements need to
be taken to fit an implant to your exact anatomy.  Have your surgeon's office
show you the charts of the implant dimensions for the various profiles of
silicone and saline from the manufacturer.  Then you and your surgeon can
piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan.  Keep in mind
larger implants tend to have more problems over the years.  Since silicone implants wrinkle less than saline
implants, they might be your best bet.

You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra.  Wear this around the house for a while, and
see what you think.  Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
 Multiple measurements of your chest wall
are taken (seven in total).  Implant size
selection has been an issue of much discussion.

Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.  Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape.  A photo album of patient
pictures is maintained to assist them.  These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery.  In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover.  Finally,
your verbal requests are factored into the analysis.

We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals.  It is a surgical procedure that
uses special instruments and techniques to minimize tissue damage and avoid
touching the ribs. It causes far less trauma to surrounding tissue than traditional
approaches, and it dramatically reduces pain and recovery time. In published
studies of BA patients, 95-percent of women interviewed after the procedure
returned to normal daily activities within 24-hours. Quick-recovery BA is not a
“gimmick.”  These specialized techniques,
which actually speed recovery and get you back to your daily routine, kids and
work, are published in our plastic surgery journals.  Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.

Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons).  Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year.  Be sure the PS has been in practice for a
while, about 20-years might be a good gauge. 
Does the PS offer all three incisions? 
Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach." 
Ask to see their before and after photos if you didn’t see any on their
website.  If they are experienced, they should have several 100 breast
implant patients for you to view.  I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you.  You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center.  Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.

All the best, “Dr. Joe”

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The size of implant best for you is dictated by your
chest wall measurements.  Once we determine that we can choose the profile
based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.

Silicone will give you a fullness at the
top (upper pole fullness).

Silicone implants come pre-filled with a
silicone gel and are the softest implant available. They feel more natural,
which makes them a good option for women with less natural breast tissue; but
they require a larger incision. It may be more difficult to realize if this
type of implant has ruptured, so it is important to monitor them with annual
follow-up visits. Additionally, because this implant contains a more liquid
silicone (less cross-linked), if this implant should rupture, it will leak only
into the scar capsule formed around the implant but may cause some discomfort
or implant distortion.

Anatomic gummy bear implants might be a
good choice to give you volume.

These highly-sought-after, anatomic
implants offer a look that more closely resembles the natural silhouette of a
breast, and, therefore, are a very attractive option for individuals seeking a
natural-looking, aesthetic primary breast augmentation. Additionally, these
implants are an especially excellent option for patients undergoing restorative
or corrective breast surgery because they provide more stability, shape, and
reduced incidence of capsular contracture. Compared to other types of silicone gel
implants, the silicone in the cohesive gel implant is more cross-linked;
therefore, should the implant shell “rupture,” it maintains its shape and
silicone does not leak.

During your breast augmentation
consultation, you should feel the different types of implants available, and
try on various implant sizers in front of a mirror to help you to get an idea
of how you will look following the surgery. You should also bring pictures of
the look you would like to achieve, as well as a favorite top to wear when
trying on implant sizers.

The best way to assess and give true
advice would be an in-person exam.

Please see a board-certified plastic
surgeon that specializes in aesthetic and restorative breast surgery.Best of luck!

Dr. Schwartz

Board
Certified Plastic Surgeon

Director-Beverly
Hills Breast and Body Institute

#RealSelf100Surgeon

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.  Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of know words such as “natural” or "some fake is ok” or "circle boobs" etc means different things to different people and therefore prove unhelpful.Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Curtis Wong, MD · Answer

I suggest you find another surgeon for  second opinion because your surgeon is imparting his/her personal beliefs on your procedure.  If properly counseled, patients should be able to make this decision for themselves.  In my practice, when patients are torn between adjacent sized implants, they are ALWAYS told to go with the larger choice as the biggest regret over my career is that they wished they went bigger after they healed.

Robert A. Hardesty, MD, FACS - Account Suspended · Answer

Dear Mrskaylahatton,Thank you for your questionS, information and photos. You are to breast congratulated  on researching your options. Unfortunately with out  a exam of your tissues I can can only comment based on the information provided, however I hope you find my comments helpful.The "best" implant choice is based not only on volume but other important factors.My answers to your question is based on my experience. Your anatomy will dictate some of the mutually agreed upon decisions both you and your chosen Plastic Surgery will make.Breast size is a very personal choice. The correct answer is what proportions you want to achieve. Sometime bigger is not always  better.My responses are:1)sizing:   A)purchase several bras (full bodied and no padding) of the size you think you want to       be. As you realize there are no standard bra (strap/cup) sizes.   B)take a measuring cup (1 oz=30cc) place rice in a nylon    C) try on various volumes of rice with some form fitting clothes.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 nipple will look.   C) the base width of the breast should equal the base width of the implant    D)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).3)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.Caveat: the bigger you go the faster you will fallI suggest you make out a list of your questions and select several nude "model" photos of what your desired goals/look would be and then schedule several different consultative appointments with experienced Plastic Surgeons who are Certified by the American Board of Plastic Surgery and who are ideally members 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, FACSDiplomate and Certified by the Am. Bd. of Plastic Surgerywwwimagineplasticsurgery.com4646 Brockton AveRiverside, Ca 92506(951) 686-7600

I'd like 475 and 500cc implants, but don't want to be too round. Is this the right choice? (Photo)

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