Can’t decide between 425cc and 450cc! Help? Surgery Dec 22, 2017 (Photo)

Hello and thank you for your question.  Congratulations on your upcoming surgery.  The
best advice you can receive is from an in-person consultation.  It would be helpful to know your individual breast measurements in order to give accurate advice in selecting 425 or 450cc.  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.   

Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Hi akosak,

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

My best advice: more communication.
It is definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?
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.
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 helps. Best wishes for an outcome that you will be very pleased with. 

To choose an implant consider the following suggestions:• Consider the fact that most people regret not going bigger (if there are regrets at all)• Make sure you know whether or not you are okay with the implants being wide and touching your arms when you walk.• Try some sample implants in the Physician's office.  Try an implant that is "too large" and one that is just right.  Usually I find that somewhere in between is a good post operative fit.• Consider the fact that on side profile if your nipple is at the bra line (without a bra on) you may need a lift.These are just a few suggestions that I use personally.  Physician's vary in the preoperative assessment but I hope this helps.
Having said that 25 cc's is not much of a difference.  The photos do show more noticeable fullness in the breasts with clothes.  This means that you will appear to be slightly "busty" which is fine if that's what you want.  I tend to appreciate a post operative result that has a noticeable difference in size and I think you will get that with either of the implants that you have chosen.  One thing you may want to consider is going with a "gummy bear" implant.  Allergen has a "highly cohesive" implant and I believe Mentor has a comperable implant as well. The reason that I mention this is that even at smaller sizes you can get a nice amount of cleavage.
Dr. Dillon