Is 345 cc enough to be a D cup for me? (photo)

It would be interesting to know the height and weight of the questioner to get an idea of their frame size. In general, a D cup would not be achieved with a 345 mL implant although honestly, there is no standard as to what a D cup is. Probably of more concern is the very short distance from the nipples to the inframammary fold and a larger implant, for example 400 mL, has a larger diameter and would require manipulation of the fold under the breast. It is difficult with a photograph alone and not a physical exam to determine how tight the skin at the fold is in may be one of the reasons why the surgeon suggested a bit smaller implant which may be more realistic in getting a good result. Remember also that fat transfers can be performed after primary augmentation if one feels that primary augmentation would benefit from that. In my practice it is very rare to do a fat overlay although there is a percentage of plastic surgeons that are embracing this.

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins").
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.
With regards to your specific question, your plan seems reasonable. Constricted or tuberous breasts sometimes require a careful more conservative approach. Often times, patients will require revision or upsize to reach ultimate goals.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Thank you for your inquiry!! Come in for a consult and try on some implants. See what size your prefer.
We would love to meet with you to discuss your concerns. Schedule a consultation with a Board-Certified Plastic Surgeon to discuss your goals.

Hello and thank you for your question. Honestly, a formal in-person evaluation would be needed to determine the best treatment. There are several reasons for this:
1) Bra sizes vary based on the clothing store (for example, Victoria's Secret tends to upsize everyone by a whole cup size)
2) Most women do not wear the proper exact fitting bra size for their bodies
3) The exact volume (in cc) needed to change cup size is different for different body types (e.g. 32A to 32D requires a different implant size than 38A to 38D)
4) Be careful NOT to fall into the trap most women do- they see a certain implant size (e.g. 285 cc) or perhaps their friend had a certain size, and they want or request this or another size based on that. Everyone's body is different- 285 cc implants on your friend might look VERY different than they would on you. Be very careful not to make this mistake, because the goal is to find the right size and shape for YOU- for your particular body and your breasts.

Because of those multiple factors, and because it is KEY to fully evaluate your breasts in person to make a full set of precise measurements to select the proper implant for you (incorporating factors like amount of breast tissue, implant type, base width, projection, etc), answering your question really would need a formal personalized consultation- to say anything before that would simply be guessing, which would be both unfair and unhelpful to you.

Your breasts are such a KEY area of your body and your femininity- therefore, you should ONLY trust an experienced aesthetic plastic surgeon. As such an expert, I have had extensive training and experience with complex aesthetic surgeries under a multiple world-renowned experts in the field. I’d recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with aesthetic plastic surgery procedures) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Thanks for your question! When women have tuberous breasts, there are absolutely size limitations. The key is getting a good result in the first surgery. Then, down the road, you can go larger if you choose to. I would not do fat grafting out of the box, but that is just my preference. Good luck!