What Size Do You Recommend to Get a Natural Look, 230cc or 280cc? (photo)

Hi there-

It is my strong opinion that recommending a breast implant for you without examining you is a bit irresponsible, especially when you consider the fact that if the implant you as a result of what you read here does NOT make you happy, it is your poor, unsuspecting surgeon who will have to manage the problem.

I have probably said it a thousand times on this site- you should spend a lot less time and energy worrying about the implant, and spend that time and energy making sure you chose your surgeon carefully (based on their education, training, credentials, and outcomes, and to a much lesser extent on their personality and online reviews), and on carefully and honestly communicating your goals for appearance with that surgeon.

If you choose your surgeon carefully and communicate well with them, your chances of being happy are MUCH greater than if you ask a thousand of us who have not met you what we think you should do.

Either the 230 or the 280 mL will likely give you a natural look. Do you want to err on the side of being bigger or smaller. Many women wish they had gone with the bigger size once all the swelling goes down.

Patients tend to spend a lot of time trying to determine the perfect implant size.  It is often difficult or nearly impossible to determine with certainly a patient's post operative bra size.  Every patient heals a little differently and their tissues accomodate to the implants in a unique way.  I typically have patients look at photos of women with a similar body frame who chose a variety of different implant sizes.  I also have patients try on different sizes to give them an idea of how their volume might change.  Some plastic surgeons prefer much more sophisticated methods utilizing computer programs and phototography.  Oddly enough, there are even aps for phones that can alter patient photos.  Unfortunately, none of these methods are perfect.  Often the advice of an experienced board certified plastic surgeon is the most trustworthy source. It is also important to remember that the final cup size is also determined by the amount of breast tissue present before surgery.  In my experience, there really is not a big difference between 230cc or 280cc implants, maybe a third of a cup size on average.  It is more important that an implant with the appropriate base width be used to avoid the appearance of an overly narrow breast. 

There is not a large enough difference in the implant volumes you have chosen to make one a bad choice and the other a good choice.  In my practice, I base the implant choice on factors such as breast width, breast shape and volume, and what size the patient desires.  Intraoperatively, the use of implant sizers allows me to choose the best implant to meet the patient's goal for size as long as the breast shape remains natural.   I recommend that you review pictures with your plastic surgeon to determine your goals, then allow your plastic surgeon to make the decisions intraoperatively as to the best implant size to use.

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

There are various factors regarding how you want your breasts to look and feel, but if you and your doctor have a good, open line of communication, you shouldn’t need to go back and forth on your decision. A major factor that effects how breast implants look and feel is whether they're inserted over or under the chest (pectoral) muscle. If you want the most natural-looking breast you'll need a subpectoral implant, in which the implant is placed under the muscle. Depending on whether a saline or silicone implant is used this procedure only requires the merest incision - about three centimeters in the crease under the breast or at the edge of the nipple.  It’s thought that placing the implant under the muscle diminishes the incidence of capsular contracture, the formation of hard scar tissue around the implant which occurs in 10 to 30 percent of cases. Subpectoral implants aren't right for everyone, though. If you have saggy breasts, an implant placed under the muscle won't fill out that empty breast sack, and you'll get what we call the "double bubble" look, where the implant is situated next to your armpit and the breast hangs several inches below it. Instead, you can have a procedure called augmentation mastopexy, in which the implant is placed under the muscle and the skin on the breast is lifted and tightened. In short, you must know -- realistically -- what you are starting with, as well as what you want to look like when surgery is done. Do you want a natural appearance or a round, perky look? These are some of the factors I weigh with my patients when evaluating what type of procedure to do.  

There are lots of factors to come into play with what size cup you will be after breast augmentation.  The size of the implant and your own tissue is the most important.  A women that is about 5 foot 6 and weighs about 120 lbs would be a mid C with about a total of 520cc (their breast volume PLUS the implant size).  A B cup to C is about 450cc.  This would be smaller if the frame is smaller, and different if the women is 6 feet tall. 

Other factors are the shape of your chest (pectus carinatum or pectus excavatum) .  The most helpful in my practice in picking size is trying on sizers in a bra.  Photos of what you wish can be very helpful also.  But find someone that is about your same height and weight, and frame size. 

The profile of the implant that you pick is very important as well.  The higher the profile, the less cleavage (for the same size implant) but the more roundness on top you will get.  Just a different shape from one to another, but it makes a difference depending on your shape of your chest and size.

Good luck.

Unfortunately, there is no direct correlation between  the size of breast implants  and the resulting cup size.
In planning your breast augmentation procedure it will be very important to communicate your size goals with your surgeon.  in my practice I find the use of goal pictures to be very helpful.  in your case you could use your own before breast-feeding pictures as the goal. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
 

Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.


I 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. 
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

I believe that the most important for a natural look is the diameter of your breast and then picking a diameter implant that corresponds with that diameter. Then you end up with minimal gap between the breasts and a natural look.

There is very little difference between the implant sizes you are considering although the impact will be more significant on a person of your petite stature than in a woman who is taller and heavier. Your breasts have mild tuberosity and the implications of this on the surgical outcome should be discussed with your plastic surgeon.