I would like a second opinion, is 405cc too big for my body? (Photos)

hi  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".  Higher profile implants tend to have a smaller diameter.  Higher is really a marketing term, but often translates into the same volume implant with a narrower base.  Saline implants actually tend to decrease in diameter as they are inflated!  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”

 

 

Thank you for your question.  I do think around a 400 cc implant would bring you close to your goal.  Depending on the measurements of your breast would determine if you should use a moderate plus implant vs a high profile implant.  A high profile implant will help more with the upper pole and potentially able to use a slightly smaller implant.  Best of luck to you. 

Hello dear!
Thank you for your question and provided information as well..
Based on your photos, it seems that you have symmetrical breasts for which you wish to add more volume. There are many ways that plastic surgeons perform measurements in order to determine which breast implant size, style and shape will best suit your goals. It is important that you communicate to your board-certified plastic surgeon what are expecting, to make certain that your goals are realistic. It's helpful to show pictures of results you'd like, but please keep in mind that these are other people and your body is different from everybody. In my office, we use a method of sizing with silicone gel forms of known volumes. This is proven to be a very accurate means of determining what size will might be of additional interest to you as well.
Know that the size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   
Hope this helps and best of lucks.
Dr. Luis Mejia.