34B, 5’4 & 140lbs, is 340cc moderate profile too much for a natural look? (Photos)

Question

I told my doctor that I wanted a natural look—nothing too large or overly "enhanced." My goal was to achieve a full B or small C cup. However, at my final consultation, he explained that, due to my measurements, a smaller implant isn’t possible and suggested 340cc, which would bring me to a full C. This left me feeling a bit uncertain, as from the before-and-after photos, 340cc looks larger than I envisioned. For reference I am a 34B 5’4 and 140lbs.

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. 
Based upon your photos, your implant choice seems reasonable. Cup size prediction is by no means an exact science. However, I would revisit your options with your surgeon and perhaps establish a range of sizes which would be acceptable which will allow for some flexibility intra-operatively.
As always, discuss your concerns with a board certified plastic surgeon.

Daniel Barrett, MD · Answer

Dear Enthusiastic4842,

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

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.

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 hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Chet Mays, MD · Answer

Thank you for your inquiry!   Typically you try on implants at the office and get an idea of how they will look on your frame.  Make sure to pick the size you like.  We would love to sit down with you to discuss these.  Schedule a consultation with a Board-Certified Plastic Surgeon to discuss your goals.

Brian K. Reedy, MD · Answer

I would suggest talking to your surgeon. Express your concerns and see if there is a happy medium - perhaps a lower profile implant. If you are still feeling uneasy, you can always seek out another opinion. Good luck!

Gianfranco Frojo, MD · Answer

There are specific techniques in implant selection called tissue based planning. If your doctor utilized this method, your breast measurements dictate exactly what type of implant range is recommended. I do not think that 340 is an inappropriate size and might actually be quite close to your optimal fill volume.

Joel Patrick Maier, MD · Answer

340 ml may be a bit large for your body and expectations. Sizing with implants in the clinic can be helpful to boost your (and your surgeon's) confidence. This way you can participate in the final size of the implant. Reviewing photos on Realself will also help. Thank you.

Leila Kasrai, MD, FRCSC · Answer

Please try on sizers at your surgeons office. You can select the implant size you’d think would be better for you, and then ask your surgeon if it would be possible.

Gary M. Horndeski, MD · Answer

At size 34, each 100 cc of implant corresponds to 1 cup size change.  340 cc implants would take you up  3 1/2 cup sizes.  That is more than enough to achieve your desired result.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

It's unclear whether or not you saw your doctor in person or just by virtual consultation. Regardless, any surgeon who is willing to play the 'let me guess what implant will give you a specific bra size' is a surgeon you don't want. That game is too risky and doesn't get to the route of the issue: it's not about what bra you think you want, it's about how you are going to look in clothing; i.e. proportions. The best way to accurately determine the appropriate sized implant for you is in office sizing prior to surgery.

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