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

Question

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??

John LoMonaco, MD, FACS · Answer

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.

Gary M. Horndeski, MD · Answer

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

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

Michael E. Decherd, MD, FACS · Answer

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!

Gerard Lambe, MBChB · Answer

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

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

Answers (9)