54, 5’3” and 148 pounds. Will 550 cc be too big for my frame? (Photo)

Dear trysh1231,

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

Thank you for your question. With a donut lift, going very large increases the risk of areolar widening, flattening of breast shape, and bottoming-out over time, especially as you’re planning to lose ~15 lb. A 450 cc (or even 400, depending on your base width and implant profile) will usually look more proportional and be kinder to the lift than 550 cc, which is heavier and more likely to stress the skin and the donut scar. Choose size by measured base width and a profile that matches it rather than by cup label, and confirm with in-office sizers/3D imaging. If true ptosis exists, consider a vertical (“lollipop”) lift instead of relying on a donut with a large implant. During your in-person examination with a board-certified surgeon, he/she will verify base width, skin quality, lift pattern, and finalize 450 vs 550 based on your measurements and weight-loss plan.

Many factors enter into choosing the ideal implant volume. Some of these factors are objective and others are subjective. It is therefore impossible to answer your question based on the limited information and single photos provided. My personal opinion would however favor the smaller 450cc implant.

Your surgeon will provide you with a range of sizes based on your anatomy and goals. You can then try on sizers at your surgeon’s office. This would be the easiest ways to see and feel your predicted results. Make sure to bring in a bra in the size you’d like to be.

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.
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.
Based upon your photo, your photos you are a reasonable candidate. More advice without exam/measures is not possible.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Hi, the choice of implant size is extremely important to the outcome, obviously. It would be a great idea to go to your plastic surgeon's office to try on the different sized implants. Then you can get a better idea of what to expect. Definitely do this before you commit to a size for your surgery. Best of luck!

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

Your breasts are slightly lower on the chest wall than ideal. A donut mastopexy can produce a small amount of lift. However, 450 cc or 550 cc implants weight over 1 lb. each and will not fit retro-pectoral. They will extrude inferiorly and laterally and the breasts will bottom out. I recommend a breast lift using 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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.