Breast lift and augmentation - 210cc vs 240 cc?

Question

Question: 210cc of 240cc?  Mother of three planning to have breast augmentation with lift. I am on the border of needing a lift and decided to do it because the upper pole of the breast is very deflated/nonexistent.  Implant info: Natrelle inspira, silicone, moderate profile,  below the muscle. Not sure if I should do the 210cc or 240cc. Breasts are symmetrical and the base width is 11cm. 5'6" 115lbs. Shoulder to shoulder I measure 16in. Prior to kids I was a 34 B (medium B). Goal is a full B maybe small C natural looking. I love the look of the 210cc but will they look smaller like the next size down (195cc) once everything settles in a few months? If so is the 240cc a better option? I workout 5-6 days a week and run three times a week.  Maybe the smaller size is better.

Chet Mays, MD · Answer

Thank you for your inquiry. We would love to sit down with you and discuss your goals. I would recommend trying on both sizes with a sports bra and bring different shirt options to see the look of each implant. The sizing is very close and could look smaller once implant is put in. Schedule a consultation with a Board Certified Surgeon

Daniel Barrett, MD · Answer

Dear wilson03,

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

John L. Burns Jr., MD · Answer

The difference in these 2 sizes is about a tablespoon of volume.  With a breast lift with implants there are always several variables.  In most cases your surgeons will use an implant sizer to determine which implant looks best and is most in line with your goals and expectations.

Leila Kasrai, MD, FRCSC · Answer

30cc is a minor difference. The difference is about 30grams, therefore it may not make a significant difference in either weight or appearance.

Robert M. Lowen, MD · Answer

Either implant will look very much the same.  When patients try on sizers and they are undecided about the two sizes they like, and both look OK, they usually choose the larger one.  The breast can look a size smaller a year later with resolution of swelling, stretching of the skin envelope, and possibly some breast tissue atrophy from the weight of the implant.
  Since your goal is full B, "maybe' small C, with emphasis on the maybe, the larger one  is less likely to cause you to feel you went too big.
  All this is subjective, dependent on your particular preferences.  Usually trying on gel implants in a bra solves the question for my patients.

Gary M. Horndeski, MD · Answer

The most important thing is the type of lift you are having rather than implant size. There is very little difference between 210 and 240 cc implants. At size 34, that corresponds to less than 1/3 of a cup. It would be better if you submitted your question with photographs to give a more accurate answer. The breast lift technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

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.
With regards to your specific question, I would not struggle over a 30 ml differential. This volume is less than the volume of a shot glass. It is unlikely to make a significant difference in the final outcome.
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. 
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Ted Eisenberg, DO, FACOS, FAACS · Answer

The size is similar and the recuperation would be the same; Choosing the right size implant for you: After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Mats Hagstrom, MD (license on probation) · Answer

I don’t think it’s appropriate for us to give recommendations on what implant size to use.
This is something your plastic surgeon should be helping you with.
Each plastic surgeon will have their own way of guiding patients through the implant selection process.
Some plastic surgeons ask patients to make the final decision regarding implant size.
Putting an implant in your bra and seeing what it looks like it’s not very accurate in my opinion.
The implant doesn’t look much smaller Behind the pectoralis muscle that it does in front of your breast.
Other plastic surgeons will make the final decision based on input from the patient.
My personal preference has always been to work with before and after pictures of previous patients who had similar body characteristics.
I asked patient to bring in ideal outcomes, especially using before and after pictures of patients with similar breast characteristics.
 Once I have a good understanding what the patient is hoping to achieve I bring those pictures with me to the operating room to use as reference.
During surgery, I use temporary implant sizes to determine what size implant will give the desired outcome.
This requires maintaining an inventory of implants or shipping back all the unused implants after the procedure.
I usually have a full selection of implants at my disposal during the procedure.
 In my opinion, working with temporary sizers has been the most accurate in my opinion.
I think the plastic surgeon isn’t a better decision to decide implant selection because they have more experience.
If the patient makes the decision than the doctor is off the hook if the patient isn’t happy with the choice later on.
 Therefore, there is some potential risk for the provider if the surgeon makes the decision which I think is better.
I don’t like talking about cup sizes and I generally work with pictures because everybody understands what small medium more larges when we look at pictures of breasts. Needing a lift with an augmentation is fairly straightforward.
Your surgeon should’ve walked you through that decision making process as well.
I generally recommend people consult with several providers before selecting a surgeon.
Finding the right plastic surgeon is usually the most important variable most likely it’s more important than selecting between the two implants you mentioned.
The hands of the right plastic surgeon everything falls into place.
Average plastic surgeons deliver average results.
Consistent exceptional outcomes comes from exceptional plastic surgeons.
 As a general statement, I don’t think patients are very good at selecting providers.
By having multiple consultations people usually get better at the process.
Regardless of which implant you choose, neither one would be considered aggressive and I think you’ll probably be fine either way if you want a modest outcome.
Most plastic surgeons will tell you that many patients wish they would’ve chosen a larger implant during long term follow up. 
For that reason, many plastic surgeons encourage patients to go with the bigger implant they feel comfortable with.
Implant size is obviously highly related to the size of the person.
At 5 foot six and 115 pounds. You probably don’t need anything much bigger than that to see a significant improvement.
Anytime, excessively large implants are used the chance of undesirable side effect, complications and need for revision surgery will go up.
Because your implant selection regardless is fairly modest I think you’ll do just fine.
It’s wise to not opt for excessively large implants that don’t fit the diameter of the breast.
All the Best with your upcoming decision-making and procedure.
Mats Hagstrom MD

Breast lift and augmentation - 210cc vs 240 cc?

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