Why would one doctor tell me I can get 700cc silicone implants, and another tell me I cant go no bigger than 550cc?

I'm around 5'6 and 145lbs and currently a 34 A. I want 700cc silicone. One doctor said that he could do this, with incision thru arm pit. And even insisted bigger around 750cc. However the 2nd Dr. told me I couldn't go no bigger than 550cc. With the incision done under the breast fold. The reason she says I cant go any bigger is because I don't have enough breast tissue and she cant fit such a huge implant in, she wont be able to close my incision. Why would one say yes and the other say no??

Doctor Answers 9

Best Breast Implant Size

Its hard to give advice without seeing your photos, but the most important rule in breast augmentation to avoid problems is this: "do not place an implant that exceeds the breasts' ability to hold."  So I am concerned about going from an A to a 500cc implant or up.
A biometric approach (where your tissues are carefully assessed and measured) is necessary, and then your doctor should recommend what size range is best for you.

Houston Plastic Surgeon
5.0 out of 5 stars 270 reviews

Difference in Doctor Recommendation for Breast Implant Size

There is a huge variation among physicians doing breast augmentations. Many are not plastic surgeons and many are not even surgeons. Most board certified plastic surgeons choose implants that both fit your body measurements and your desires. Some others will insert whatever you desire. Personally, I choose the range of implant and then discuss which implant within that range best fits the patient's desires.  his is one reason I have a redo rate of

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 6 reviews

700cc implants

You ned enough skin to fit the implant in and the doctors have a difference of opinion but I would say going from A cup to 700cc is likely to give you problems with ripples , capsular contracture, wound healing and bottoming out over time. You can look ups examples of these problems on here.
Good luck with your operation

Gerard Lambe, MD
Manchester Plastic Surgeon
5.0 out of 5 stars 15 reviews

Large breast implants = higher risk for complications

Thank you for your question. Please realize that 700cc implants are very large and are more likely to cause problems for you sooner than smaller ones (<300cc).  Typically, large implants are associated with complications such as:  chronic pain, skin stretch deformities, irreversible soft tissue damage, capsular contracture , malposition, double bubble deformity, nipple numbness, etc.  The laws of gravity do not cease to exist on your chest - the larger the implant the sooner it will sag.  Unfortunately, there are some PS that will do what you want, regardless if it's not in your best interest long term, I urge you to visit the breast inplant revision forum on this site to learn about the risks associated with larger implants from real women.

I hope this helps.

Best wishes and kind regards 

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 222 reviews

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

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

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 91 reviews

Size question

It all depends on your base with of your breast--I try to match the width of the implant to the width of the woman.  You can then select low, medium, or high profile.  If you are wide enough to get a 700 cc implant, fine.  If your are not wide enough, then it would stuck out into your armpit.
I think personally it would be hard to get a large silicone implant in through the armpit, without the implants lateralizing.
Good Luck!

Michael E. Decherd, MD
San Antonio Plastic Surgeon
4.9 out of 5 stars 54 reviews

Large breast implant

Sometimes what we want now is not what is best for us In the long-term.
I would highly recommend that you avoid any implant larger than what your body measurements indicate is safe. Based on just your height and weight alone - I would doubt that an implant over 450cc is a good choice for you in the long term. Ultimately - the amount of breast tissue present, the stretch of your skin and the width of your rib cage will help define the best implants you. 
Implants that are too large for your body will cause you to actually lose breast tissue in the long run because of the pressure from the large implant. You will also require a lift much earlier than you would otherwise. This then leaves you with thin tissue and extra skin making the next operation much more complicated. 
Once you commit to a very large implant - the changes to your body can not be easily reversed. Please seek out a board certified plastic surgeons who discusses the above facts with you during consultation.  

Jon Kurkjian, MD
Fort Worth Plastic Surgeon
5.0 out of 5 stars 44 reviews

Different recommendations regarding the size of your implant?

Every surgeon will have a different opinion regarding the size of the breast implant that is best for you.  Without examining you it is difficult to tell you what the is the best answer.  However, I can give you some general information.  Frequently, the size of a breast implant is dictated by your anatomy -- your skin tissues, your breast width, your chest width, etc.  If an implant that exceeds these dimensions is used, you are much more likely to have problems after surgery such as excessive thinning of your skin, and the implant being too high or too wide (think of the implant being in your armpit everytime you try to use your arms).  Additionally, women with large breasts may experience back pain, neck pain, headaches, and other symptoms consistent with macromastia.  This is true regardless if your breasts are naturally or are large due to implants.  I would suggest that you consult with a board certified plastic surgeon to discuss which implant is best for you.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 18 reviews

Differing opinions regarding possible breast implant sizes...

Thank you for the question. It is extremely common to receive different opinions from different plastic surgeons about the best way to treat a specific “problem”. Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices. It is quite amazing how adamant each plastic surgeon can be about the superiority of his/her recommendations…

Although these different opinions can be confusing and a source of anxiety for patients, it is good for patients to understand the different options available. Ultimately, it will be up to each patient to do their due diligence and select their plastic surgeon carefully. Part of this selection process will involve the patients becoming comfortable with the plastic surgeon's experience level and abilities to achieve their goals as safely and complication free as possible. If I were you, I would ask to see as many examples as possible of similar patients who your plastic surgeons have helped with breast surgery.

 Having said that, every patient undergoing breast augmentation surgery should understand that their anatomic starting point will limit the outcome of breast augmentation surgery.    In other words, a patient's starting anatomy will limit how large of a breast implant can be utilized safely. The use of a larger breast implant(than what is safely "allowed" by the patient's anatomy) can be problematic;  potential problems include breast implant displacement/malpostion issues ( such as bottoming out, lateral displacement, symmastia...)  and/or significant breast implant rippling/palpability. I emphasize, to every patient undergoing breast of patient surgery, that safety and avoidance of complications should be everyone's first priority. Sometimes, when a patient wishes to achieve a relatively large outcome, more than a single stage operation is necessary to safely do so.

Ultimately,  careful selection of plastic surgeon, 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, and computer imaging) 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 "D or DD cup” 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 larger breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.