105 lbs and 5"3. Would 400-500cc would be too big for me?

I think you should stick to your guns and get what you originally determined was your goal - 275 cc and silicone. I feel uncomfortable hearing another surgeon talking you into saline and bigger than your original goals. Consult with a board certified plastic surgeon who will listen to your goals! Best wishes, Dr. Aldo

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.   The size,
profile, and shape of the implant is based on your desired breast
size/shape, your chest wall measurements, and soft tissue quality. 
This decision should be based on a detailed discussion with
equal input from both you and your surgeon.   Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their
results.  
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

It is possible you have some features (e.g. very loose breast skin) that your consultant may be trying to address with a larger implant.  You would be well-served by obtaining consultation with another surgeon before proceeding with surgery.

If you want you can request bra-sizing trials with the bra
of your choice to finalize the size you want as long as it is in the acceptable
boundaries.

Please note that we want to achieve long-term aesthetic
results, and so we should not go too big or too small as you already affirmed.

That being said, the implant
size has to fit your body dimensions. The more you deviate from the proper fit,
the more fake your breasts will look. Your surgeon may have used tissue-based
planning to determine the implant size. The planning takes into account
the effects of implants on tissues over time, risks of excessive stretch,
excessive thinning, visible or palpable implant edges, visible traction
rippling, ptosis (sagging), and breast tissue wasting.  

To determine the final implant
size, breast measurements such as breast base width, breast skin stretch, and
nipple-to-inframammary fold distance. The combination of these measurements
will help determined tissue coverage and the required implant volume to
optimally fill the breasts. Without this information, we cannot be of much
help.

Please share all your
motivations for surgery, your concerns, your expectations and goals with
complete honesty and clarity. This will help prevent post-operative
concerns/regrets. If you trust your surgeon and their judgment and the
decision-making method used to choose the implant size, then you should be in
good hands.

Hope this helps.

I appreciate your question.



The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  



Silicone will give you a fullness at the top (upper pole fullness).



Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.



Anatomic gummy bear implants might be a good choice to give you volume.



These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.



During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.



The best way to assess and give true advice would be an in-person exam.



Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.



Best of luck!



Dr. Schwartz



Board Certified Plastic Surgeon



#RealSelf100Surgeon



#RealSelfCORESurgeon

Without an examination or even pictures to review, it is impossible to say what will work best for your frame.  However, in general, 400-500cc is a pretty big volume for someone who is 5'3 and 105lbs.  I recommend consulting with a few more board certified plastic surgeons and see what they recommend. I hope this helps.

400-500cc does seem to be rather large for your body size. I would suggest you get a second opinion from a board certified plastic surgeon. You should be able to try on implant sizers (in a bra) in the office and and see how different size implants look, in a mirror. My patients find this to be a very useful tool to get the right size. It is your decision as to your implant size, the surgeon should be there to help guide you in selecting a implant and size to achieve your goals. Very good question to ask before you move forward! 

It is difficult to say what would be best for you without seeing you in person. A review of your anatomy and your goals is key.

Thank you for the question. Despite your good description of goals, online consultants will not be able to provide you with specific enough advice to be truly helpful. Ultimately, 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. Sometimes it is helpful to seek consultation with a few board-certified plastic surgeons before making your decision regarding  choice of plastic surgeon.







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 or D 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 (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes.