34B with 425cc - What Size Will I Be?

Question

Hi I'm 5"7 130 lbs 34B, had an augmentation 2 1/2 weeks ago with high profile silicone implants 425cc's. I had told my surgeon that I wanted a D cup however, I'm still swollen and my breasts look like a C cup, my friends say with 425cc's i'm more like a DD but that's definitely not the case. Is it possible that I might be a small C?

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question. In general, implant size does not correlate with bra cup size.  The cup size itself will vary from manufacturer to manufacturer as well as who is doing the actual measurements.  Thus, cup size is never a reliable indicator for your breast size.  I typically encourage my patients not to communicate her desires in cup size but more on the actual look and appearance.  Good communication between you and your surgeon of your expectations is warranted - choosing your surgeon wisely is the first step.  Discussion of your wishes and having an honest and open dialog of your procedure is mandatory (e.g, implant type, incision, placement, lift, etc).  I have found that photographs brought by the patient is helpful to get a visualization of the appearance you wish for in terms of size, shape, fullness, etc.  In addition, your surgeon's pre and postoperative photographs should demonstrate a realistic goal for you.  Once this has been accomplished, allow your surgeon to utilize his/her best medical judgment during the procedure to finesse the best possible result for you after preoperative biodimensional planning and fitting the right implant for your breast width. Hope me that this helps!  Best wishes for a wonderful result!

Tom J. Pousti, MD · Answer

Thank you for the question.

	The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size.  Much of the final &ldquo;look&rdquo; achieved after breast augmentation surgery  depends on several factors:
	1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation &ldquo;look&rdquo; will be optimal.
	 2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant. 
	3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result. On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants. Other differences involve how the breast implants are filled. Saline implants are filled after they&rsquo;re implanted, so saline implants require a smaller incision than prefilled silicone breast implants. On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers&rsquo; saline-filled breast implants are considered investigational. As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.  4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is 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 &ldquo;natural&rdquo; or &ldquo;C cup&rdquo; 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.
	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 &ldquo;I wish I was bigger&rdquo;.

	I hope this helps.

Otto Joseph Placik, MD · Answer

It is unlkely that you are truly a C cup after having 425cc implants placed in your formerly B cup breasts. This is typically a D or even DD cup outcome.

Hayley Brown, MD, FACS · Answer

All bras fit differently and there is no standardization of  cup sizes. A 425 cc implant is rarely a C, and is usually a D or DD.

Scott C. Sattler, MD, FACS · Answer

Factors affecting your post-op cup size have much to do with your chest dimensions, breast base width and tissue characteristics. Based on your self description and the implant placed- my response to your question is that you will be 'big' post-op- probably well into the D cup range. The most important thing to evaluate is not cup size, but appearance of your breasts post-augmentation. Ask your self ' Am I happy with this result?'

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34B with 425cc - What Size Will I Be?

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