Silicone Gel Implants Natural Size?

5'9, 130 lbs, 25 year old, currently 34B. I don't have any kids, so sagging is minimal and I have asked my doctor to make me a full C, small D NATURAL looking. I have selected to use the silicone gel implants.

My Dr states because of my wide shoulders and hips I can go 450-525 comfortably, but I think this is too big. I would like some nice cleavage and fullness but I don't want to be a adult movie star look-alike. I was thinking 425-475. Your thoughts? I appreciate all the help!

Doctor Answers 4

Size of Silicone Implants for a Natural Result

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What one person might describe as a natural-looking breast augmentation might be described by another as very artificial-looking.

My breast implant rep jokes that I am the biggest user of the smallest implants. In my opinion, breast implants of 450 -500 cc's even on a tall woman would appear to be an obvious breast augmentation.

However, I would never try to convince a woman to go smaller than she wants to be. I would simply suggest that she see a plastic surgeon who shares her aesthetic ideal.

While the size of the implant is critical in ensuring a natural looking result, breast implant position is also critically important. In many patients, the inframammary fold needs to be lowered in order to allow the implant to rest at a level that appears natural relative to the position of the nipple and areola, and in order to prevent the appearance of excessive upper pole fullness.

In profile, the natural-appearing breast is not convex in the upper pole, and an excessively convex and overly full upper pole is a dead giveaway that a breast implant sits below the skin. Likewise, if the inframammary fold is lowered too far, the augmented breast will appear 'bottomed out', with an excessively full lower pole, an empty upper pole, and a nipple/areola that appears to sit too high on the breast - another situation with a distinctly unnatural appearance.

The horizontal position of breast implants also requires a great deal of attention, both in pre-operative planning and in the operating room. Excessive lateral dissection of the implant pockets will result in augmented breasts with an excessively wide space between them in the cleavage area, and the appearance that the breasts are abnormally far apart. Inadequate lateral dissection, on the other hand, will result in an augmentation with an abnormal 'side by side' appearance. As it is lateral projection of the breasts beyond the lateral limit of the chest wall (in frontal view) that, along with the concavity of the waist profile and the convexity of the hip profile, produces the appearance of an 'hourglass figure', careful attention must be paid to ensure that lateral breast projection is not inadequate.

Take your time researching your plastic surgeon and look at many many photographs of women with a starting point like yours and a result that is similar to what you hope to acheive. No two women will have identical results, but by viewing mayn before and after photographs from all positions (front, side and oblique) you will be able to get a sense of whether you and your surgeon share the same idea of what "natural" breast augmentation looks like.

Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Breast Augmentation

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I think you have the right sizing. What I would do to really narrow it down is do the rice test, which what I have all my patients do. You can read about in on my website, But here is the gist of it:

take a pair of panty hose cut off at the ankles. Take a measuring cup and measure out 1 1/2 cups of rice which is about 360 cc. Pour in into the panty hose and tie it loosely. Put on a sports bra and place the rice /pantyhose into the bra and shape to cover you breast tissue. Try on a bunch of different clothes and see how things look, if too big, then take rice out and if too small add rice. When you are happy you measure out the rice with the measuring cup, which usually has cc on the side. Add 10% to your total and you have your implant size.

So if 1 3/4 cup worked for you then you have 420 cc (1 cup is 240 cc and 3/4 is 180 cc) add 10 % and you get around 460 cc.

Good luck, this is what I use to size my patients and it works extremely well.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 88 reviews

Breast Implant Size?

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Thank you for the question and pictures.

Unfortunately, it is not possible to directly correlate breast implant size and final breast cup size. “Natural looking” means different things to different people-  the use of words are subjective and lead to miscommunication. The "rice test"  and other forms  of pre-operative sizing also are inaccurate.

Communication with your surgeon is critical in achieving the results that you wish to achieve.

In my practice I find the use of goal pictures to be very helpful in this communication process.    
I also use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.

 I hope this helps.

Try the implants on in a bra

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By sizing with the appropriate dimension of an implant you can get an idea of what will help you get the look you are after. In women I see for revision from surgery years ago who complain that they have always felt they were too large, they had no say in the size implant that was used. As your plastic surgeon to allow you to size with the implants so you can see.

Dr Edwards

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.