Is 335cc too big for my frame when I’m a 32C?

Question

Hey guys, I am going for surgery in less than 2 weeks. I am 115 pounds, size 6, 5’4 and quite lean. My boobs have lost their shape over the years and upper cleavage is a thing of the past for me. My surgeon recommended 280 moderate profile or 335 high profile based on my chest diameters being 11cm. I want nice round boobs, but don’t want to take away from my leaness and small frame. Can someone please help my sanity and let me know if 335 should be the right size for me and not look too heavy?

Gary M. Horndeski, MD · Answer

At size 32, each 100 cc of implant corresponds to 1 cup size change. You will go up 3 and 1/3 cup sizes and would be a DDD. This may be too large for you. You may also benefit from a lift. Unfortunately, you have not provided photographs. Sometimes doing a lift with implants, you can get a smaller implant and get the appearance you desire by aligning the nipple, breast tissue and implant to maximize anterior projection with smaller implants.

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.
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. 
With regards to your specific question, I would not struggle over small volume variations (55 ml is only slightly more than a shot glass). I have found, in my experience conservative sizing is best. That being said, petite patients often do better with high profile devices which deliver greater volume in a smaller space.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Daniel Barrett, MD · Answer

Dear Diligent126434,
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

Leila Kasrai, MD, FRCSC · Answer

Sizers can help you in this situation. These are implants that you can fit into your bra to see how you may look after surgery.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size 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

Ronald J. Edelson, MD · Answer

335 cc implants are reasonable given your build. It shouid make you a mud to full C cup. If you look at photos on websites it will give you an idea about size choices

Camille Cash, MD · Answer

Many surgeons have sample implants that you can "try on" to help you get a feel for how you may look after surgery.  I encourage you to return to your surgeon's office to discuss your concerns and review the implant choices again.  Without examining you they both sound like appropriate choices.  The 280cc implant would give a more conservative look.

Connie Hiers, MD, FACS · Answer

I would suggest going back to your surgeon and actually trying on that size so you can see how this will look.

Daniel P. Markmann, MD · Answer

Choosing implant size is a very difficult decision for most women.   I use something that is called Vectra imaging.  It shows you exactly what you will look like with any size implant.   If you are debating between 2 sizes, definitely go with the larger.   It is extremely rare for a woman to think they are too big after surgery.   But, it is very common for women to "wish they were bigger".  Almost every woman has a fear of being too big and then error on the side of caution and choose a smaller size than she really wants.