165 cm tall, 57 kg, with a breast width of about 12 cm. Best size for my frame - 300/340 vs 320/360 (Motiva Demi)?

Question

Hi everyone, I would really appreciate your advice because I’m struggling a lot with my implant size choice. I actually got really helpful advice here before when I was deciding on the type of implant, so I’m hoping you can help me once again with the final decision. My stats: I’m 165 cm tall, 57 kg, with a breast width of about 12 cm. I’ve had children and breastfed, and I’ve lost quite a bit of volume, especially in the upper part. At the moment, I have very empty breasts, currently around a B cup. My surgeon also confirmed that I do not need a lift. I’ve chosen Motiva round demi implants, but I’m very unsure about the size. My surgeon advised going at least 340 cc to properly fill everything. I also have some asymmetry, so the options would be: • 300 cc / 340 cc or • 320 cc / 360 cc In the past, I had 300 cc anatomical implants under the muscle, but I found them just slightly too small. I still felt like I needed lightly padded bras to get the fullness I wanted. Now I’m going over the muscle, and that’s what makes me doubt so much. I’m worried that if I go for 320/360, it might end up looking too big on my frame. At the same time, I’m also afraid that if I choose 300/340, I might end up feeling like they’re too small again. I would really appreciate any input on which option you think would give the most balanced and natural result, without ending up too small or too large. Thank you so much!

Daniel Barrett, MD · Answer

Dear Flolalo,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

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."
With regards to your specific question, it is unlikely that a small 20-40 cc differential will make or break a result. For comparison, 40 cc is essentially equivalent to a shot glass. This sort of differential will be arguably imperceptible post operatively.
 Communication is key as you and your surgeon create your custom surgical plan. As always, discuss your concerns with a board certified plastic surgeon (ABPS).

165 cm tall, 57 kg, with a breast width of about 12 cm. Best size for my frame - 300/340 vs 320/360 (Motiva Demi)?

Answers (2)

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