Is my Chosen Size Realistic for Breast Augmentation? Size Suggestions? (photo)

I am 5'0", 100lbs, currently 34A, was 34DD while nursing. I will not get a lift and would like to get back up to a D or DD. I much prefer subgladular b/c of weight training and I prefer the look of subglandular. As you can see from my photos, I do have some mild ptosis (I believe I am about 12cm from my areola to my Inframammary fold). A reputable PS is comfortable using a 450cc-600cc silicone HP subglandular implant. I tried some on and liked the 550. Professional feedback?

Doctor Answers 13

Subglandular large high profile implants will be bad news for you in the long run.

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Large, subglandular, high profile implants will not serve you well in the long run.  They will stretch out your skin and thin out your breast tissue and could leave you with permanent damage to your breast. 

You would be much better served with smaller, submuscular implants and, from your photos, I don't think a lift would be necessary.  Submuscular implants can feel pretty weird with upper body exercise but almost everyone gets used to it.

Many reputable and well meaning plastic surgeon put these big implants in small, thin women because that is what these women want but I really don't think it is in a patient's best interest to do so. 

A good part of my practice is devoted to taking implants out of ladies once they have "outgrown" their implants physically, emotionally, spiritually or financially.  I can usually get the explanted breast looking pretty good with a lift but when the breast tissue is so thinned out, a good lift is sometimes not possible. 

Remember, all plastic surgery is four dimensional with the fourth dimension being time. 

Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

Is my Chosen Size Realistic for Breast Augmentation? Size Suggestions?

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After reviewing your posted photos and comments I believe 450 to 500 cc would be my choice. You realize above the muscle will give a "fake" look. If you truly desire a dd cup than yes a 600 cc HP could be used. 

Breast Augmentation Size

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I think this size would look great on you!  I agree that you do not need a lift, your nipple is right in the center of your breast.  The implant will give you a larger size and more fullness up top.  I don't routinely place subglandular implants due to the higher risk of capsular contracture (bad scar tissue building up around the implant) and the small risk of it hiding breast cancer on mammograms - even in body builders - but I think it is fine if you are ok with those risks.  I think you are a great candidate for breast augmentation.  Best of luck!  K. Roxanne Grawe, MD Columbus Plastic Surgeon

Implant Selection Process

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In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 95 reviews


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This is the approach I use to help guide my patients with their implant size selection:  I consider two factors when selecting implants for my patients:

1.Dimensional planning
2.Gel Implant Sizing system

Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.

Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.  If you have decided on saline implants, then based on the gel sizer you select, we can guide you to the saline implant that achieves a similar look.
Hope this helps.
Dr. Basu
Houston, TX

Smaller implants retro-pectoral is mechanically more stable

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At size 34 A, 100 cc's of implant corresponds to 1 cup size change.  To go to a DD would require approximately 400 cc implants.  However, I do prefer silicone gel placed retro-pectoral rather than subglandular.  In the subpectoral position, there is less capsular contracture, less rippling and more mechanical support of the implant.  You may be a candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to place the implant and elevate the breast so the areola, breast tissue and implant are high over the bony prominence of the chest wall.  The advantage of this technique is that a smaller implant can be placed to achieve the desired projection.  Smaller implants are more stable over time, particularly if you are doing weight training.  A 450 or 600 cc silicone high profile subglandular implant will descend in time and you will need multiple revisions.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

A couple of additional thoughts

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I agree with what has been said here already concerning subglandular implant placement.  Especially in slender girls with thin tissues the results are not as attractive, and you will have a greater likelihood of capsule contracture.  If you are absolutely committed to sub glandular implants, one other option you should strongly consider is the use of textured, anatomically shaped implants.  I have placed a significant number of these implants, and they give very beautiful results.  I would certainly consider using them in a girl such as yourself who has thin tissues and desires subglandular implants, and I would place them in a subglandular position.  The texturing may have some benefit to decreasing the risk of contracture.  Regarding the size, my simple advice is to make cup size a secondary consideration and rely primarily on preoperative sizing using breast implant sizers as a guide.  Once you select the implants that give you the proportions and shape that you desire, whatever cup size you wind up in is the cup size that you should be.  Not the other way around.  Good luck.

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

A large implant on a small frame, is it wise?

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Mrs. E,

I most certainly do use large implants in my practice but I rarely use them in the sub-glandular space in a woman with minimal upper breast coverage. As long as you realize these larger implants will in a relatively short period of time stretch your tissues and give you visible ripples and wrinkles in the upper breast, you can proceed. This is not to say that large implants under the muscle don't also stretch the tissues, they will but not giving as much implant visibility. The larger the implant you go with with the least soft tissue coverage, the less natural your results will appear.

I hope this helps.

Dr Edwards

Small but strong; body builder wants a full breast after breast feeding

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Hi Mrs Easterhouse. Several points: 450 to 600 cc's is pretty wide ranging. I assume that you saw this but did you see the range in the size of the implants; there is a pretty significant difference between the 450 and 600 cc's? The range of size should be predictably tighter. At 5 feet and 100 lbs you probably have a low body fat %, or will, as you train. Prepectoral implants invariably thin out the breast tissue and skin over time and leave more visible rippling and visible implant edge with accelerated sagging; which is worse as the size increases. (The only thing that is supporting the implants is the skin and breast tissue). Your chest measurement is 34 so you might be ok with the 500 ccs. It depends how wide you breasts are; in any case the width is equal to the height of a round implant and they get wider and taller as they increase in size in any style of implant with little difference in projection. If you are determined to go sub-glandular then you should realize that you are looking at significant revision surgeries and possibly a pocket conversion in the future. The interval between your surgery and this is not predictable. As far as the size question, I am very pleased with our Vectra 3D, imaging system in showing size and proportion to patients. It is an awesome communication tool that I cannot replicate any other way. I would consider a "form stable" implant as mentioned by Dr. Gottlieb as it should support your breasts over time better than a reactive silicone implant and it will not show rippling. I have used submuscular implants in body builders with good results and the upper pole of the breast has a nice contour with less downside. (See above). I understand the reasons that the pre-pectoral implant is popular in body-builders. There are tradeoffs though. I can't advise you about definitive size without a "real time" evaluation. 

Is my Chosen Size Realistic for Breast Augmentation?

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A large implant on someone your ht and wt and with a 12 cm breast diameter would be in the 350-400 size area. 550 and 600cc implants will look extremely artificial. Think two large grapefruit halves under skin and breast tissue with almost no thickness.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.