Should I get 175cc or 210cc? (photos)

Question

So I went to my first consultation on my breast augmentation. I had fat grafting breast augmentation 2 years ago and now , the fat is pretty much all gone so I'm thinking about getting implants. I wanted it very natural so to get to my wish look, my doctor suggested 210cc or 175cc. Subfascial. I exercise a lot hence he suggested subfascial. Would subfascial make my breast feel fake ? And should I go for 175 or 210cc?

Kenneth Hughes, MD · Answer

In smaller women 175 cc may increase by one cup size.  The plastic surgeon you selected should be able to guide you to the correct size for your measurements and desires.  Measurements of the chest wall and breast imprint width as well as knowledge of all breast implant sizes and measurements should make this process easy.  The difference between these sizes is difficult to appreciate, and you should pick the one you like better.   A profile bra with sample implants under a tailored blouse, tight sweater, swimsuit, and other garments you typically wear will give you the best idea of whether the garments fit as desired with the implant selected.  I would recommend that you go with the size that boosts your self-esteem, and fits your anatomy.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Martin Jugenburg, MD · Answer

Thank you for your question. Difficult to answer without knowing your dimensions or assessing you in person. Please see your plastic surgeon for another consultation to discuss your questions.

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the best size you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implant

John L. Burns Jr., MD · Answer

I would suggest doing 3D photographic imaging to help you choose the perfect implant volume, shape, and profile.

Daniel Barrett, MD · Answer

Hi Gdmuimui,
  
Thank you for the photos. I think you are a great candidate for breast augmentation surgery. It is best, however, that you visit a board-certified plastic surgeon for proper and thorough assessment. 
  
In addition, 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, MHA, MS
  
Certified, American Board of Plastic Surgery 
  
Member, Am. Society of Plastic Surgery

Aldo Guerra, MD · Answer

There's on way to answer your question online and without a formal consultation. I would say these sizes you have mentioned are very similar and both can look natural above the muscle in a subfascial space. Speak with your surgeon again to remove any doubts about the surgery plan. Best wishes, Dr. ALDO

Tom J. Pousti, MD · Answer

Thank you for the question.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. Your goal photographs are realistically achievable.Ultimately, careful selection of plastic surgeon and careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
 
 Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this helps. Best wishes.

William C. Rigano, MD (retired) · Answer

That implant will increase you about a cup.  Based on your photograph, I would recommend  maybe 300 with partial muscle coverage. My patients can resume workouts and physical activity after healed. Talk to your surgeon. That full look will not be attained with a 175cc implant. Just my thoughts.

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