Two of the same size implant? (Photo)

Question

My girls are slightly different. Are they different enough to need to have different size implants? I want to do over the muscle. 350-400 I’m guessing. 5’5, 110 pounds, bwd 11/12.

Jonathan Heistein, MD · Answer

Hi.  It is very common for women to have different size breasts.  Depending on how different the volume is, it is sometimes better to put the same size implants in both breasts, and sometimes better to use a larger implant for the smaller breast.  It is difficult to say exactly for you what, if any, the difference should be because a physical exam would be necessary to make that determination.  But your surgeon should be able to tell you the options and steer you the right way.  Just from looking at your photos, my guess is that it would be better to use a larger implant in your smaller breast to improve your natural asymmetry.  Best of luck!

Daniel Barrett, MD · Answer

Dear Pioneering249277,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

At size 32 or 34, each 100 cc of implant corresponds to 1 cup size change. 400 cc implants will take you up 4 cup sizes. I recommend you consider smaller implants, particularly if you want them in front of the muscle.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

Your breasts are different enough in volume to warrant different sized implants. Given your lean upper body and small breast volume, implants placed over the muscle would likely look 'unnatural', and also likely ripple. Further, implants over the muscle tend to develop capsular contracture at higher rates, necessitating revision surgery known as a capsulectomy, which further thins your tissue. You would do best with implants placed under the pectoralis major muscle; the vast majority of women with implants under the muscle can enjoy sports, including weight lifting, power lifting, yoga, pilates, and even crossfit.

Ronald J. Edelson, MD · Answer

I would recommend same size implants. Using different size implants is a game that you just can’t win, especially with breasts that are as close in size as yours

Connie Hiers, MD, FACS · Answer

When you go in for the consultation, ask to try on a variety of sizes and you can then see what you like and if one implant needs to be larger.

Kenneth R. Francis, MD, FACS · Answer

Dear Pioneering,
Placing different sized breast implants during a breast augmentation is a bit of a slippery slope, unless there is a very significant volume difference.  The different implant base widths have to be taken into account, which will also change the projection.  At the minimal difference you have, I would place the same size breast implants.  Think of it this way.  As a percentage of overall breast volume, the current difference will decrease after your breast augmentation.  In other words, suppose your current breast size difference is 65cc and your breasts are 300cc and 350cc.  So as percentage of all of your breast volume, that is 10%.  If you then add 300cc implants to each breast your total breast volume becomes 1250cc and the 65cc difference drops to only 5%.  Either way, your results are going to be great!  Good luck!

Two of the same size implant? (Photo)

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