Should I get 500cc to 525cc to achieve this desired look? (photos)

Question

Im 5’9, 150lbs currently 34B. I’ve breastfed my 3 children so my 34B is pretty deflated. My breast augmentation is in 2 weeks. I decided on 450cc filled to 475cc moderate saline implants. I’m going for a natural look but still want them to be big and full considering my size. Should I get 500cc to 525cc to achieve this desired look?

Michael E. Decherd, MD, FACS · Answer

There is not a whole lot of difference in the sizes you mention.  It is all about the base diameter and then the profile.Why saline? We do 99% silicone...there are a number of advantages.Good luck!

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the best size you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implant.

Gregory A. Buford, MD, FACS · Answer

If you are looking for a more natural result, then you really should avoid large saline implants.  Also, best to identify a proportionate look that you are trying to achieve and make sure that your Plastic Surgeon uses sizers during surgery to effectively try on various volumes to see what looks best for you.  Most importantly make sure that your surgeon is actually a "Plastic Surgeon" and not a "Cosmetic Surgeon".  The difference is that the CS has simply taken a few weekend courses and has not completed an actual residency in Plastic Surgery.  I hope that helps and wish you the very best!Warmest regards,Gregory A Buford MD FACSBoard Certified Plastic Surgeon and Author

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation.  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.  This entire surgery
can be performed with a small incision technique.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Michael Baumholtz, MD, FACS · Answer

Some thoughts:Visit with a board certified member of ASPS / ASAPS.In our office the process goes like this 1. Measure your base diameter and use that as a starting point in terms of the change you’d like to see2. We use VECTRA to communicate with patients what a reasonable expectation following breast augmentation will be3. We ask our patients to bring pictures from the internet of the look they are trying to achieve.4. We then select saline or silicone after reviewing the pros and cons of each5. We then discuss the surgery itselfOnce you’ve selected the projection and base diameter - the cc’s are irrelevant. Unless you are dramatically changing the base diameter (or base width) or changing from one projection (mod profile to high profile) to another - you’re not likely to see much of a difference. Too many patients get wrapped up in the numbers (ie the cc’s).Hope that helpsGood luck

Robert M. Tornambe, MD · Answer

I appreciate your concern, however I would not elect to go to large with saline implants if you are still desiring a natural result.  Ask your surgeon about possible dual plane technique, as this provides some lift as well and may allow you to achieve your goals without extremely large implants.I try to tailor each breast augmentation operation to my patient's desires and body type. There are pros and cons regarding saline and silicone implants, and patient anatomy and preference play a role in selection. The same is true regarding implant projection. Be sure to consult with a board certified plastic surgeon and go to your consult with all your questions written down so you don't forget to ask something. Good Luck!

Daniel Barrett, MD · Answer

Dear Boobies1985,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

Pejman Aflaki, MD · Answer

Hello,
thank you for the question and sharing your photos.  Many factors
including patient's desired breast size, skin envelope (both quality and
quantity) and breast width diameter are important in selecting
the implant size. The method I have found most useful and is being done by many
plastic surgeons is trying a variety of in-bra sizers, during your consultation. Keep in mind
that the breasts will look slightly smaller once the implant is placed inside
the body as opposed to placing it under the bra, so I always tell my
patients to go slightly higher than the in-bra sizer they like. For
example, if you like the 475 cc, you will probably need a 500 cc implant.
In combination with several other measurements that your surgeon will do,
the final implant volume is selected. Another helpful tool, is to look at
before and after pictures of your surgeon's results and knowing what implant
size was used in each case. This will give you an idea of the kind of results
you can expect. Other things to discuss in your consultation are type
of implant (saline vs. gel), location of incision and implant pocket
(below or above muscle). Be
Pejman
Aflaki, M.D.
Johns
Hopkins-trained plastic surgeon

Steven Varkony, MD · Answer

Choosing implants is a personal process and is completely
dependent on the patient’s preference. To ensure that our patients are
satisfied with the implant sizes they choose, we have them try sizers on
underneath t-shirts so that they know what they’ll look like after surgery. We
recommend consulting with your doctor to further discuss your concerns.

Georgios Ziakas, MD, FACS · Answer

Your surgeon typically will determine what size best fits your chest size based on your aesthetic goals and anatomical measurements during your consultation. Many implant manufacturers offer sizing implants that you can use under a sports bra to determine the best look. There is also software which can show a patient the potential look based on pre- operative photos. Implant size is determined by specific measurements your surgeon takes during the consultation. It is best to visit your prospective surgeon in order to discuss your options and aesthetic goals again.

Should I get 500cc to 525cc to achieve this desired look? (photos)

Answers (16)

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