I can’t decide! 485 or 520cc and high or moderate or mod plus? (Photos)

Question

Having the toughest time trying to decide between 485 or 520cc. Difference is 35cc only... but I read once placed under muscle you loose 50cc projection. 5’4 135lb. So this is me currently & then with sizers & wish/goal boobs! I don’t want them to sit super low and not have any upper pole fullness but don’t want at chin. Hellllp pre-op is 5 days away?

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. If you are after upper pole fullness then I would choose the implant that maximizes your base width, or the widest implant that will fit your breast as this will give you the most height as well. In regards to size, just think about which final outcome you fear the most: being too small or being too large. If you fear being too small, then choose the larger of the two implants, if you fear being too big, then choose the smaller implant. You will likely be happy with either choice but make sure that your plastic surgeon is board certified by the American Board of Plastic Surgery and is helping guide you through this process.Best of luck!

Daniel Barrett, MD · Answer

Dear jesgirl1,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

Connie Hiers, MD, FACS · Answer

The implants you chose have small amount of differences. I would suggest going back to your surgeon and discussing your concerns. Let your surgeon, who has examined and measured you, help make the final decision.

Robert Singer, MD · Answer

The best cosmetic result in any particular breast
augmentation patient depends on a variety of factors, including: Your
individual anatomy, desired outcome, realistic expectations, a thorough
discussion with the plastic surgeon about the options, and an understanding of
the pros and cons of any particular implant choice. Proper sizing is not just
about the number of cc’s. or the type of implant. The thickness of your tissue,
breast dimensions which include the width, height, and projection, as well as
chest wall width all need to be considered when choosing an implant. Trying on
implant “sizers” of various shapes and volumes while wearing a tight t-shirt,
bra, or bathing suit at a preoperative visit will help you and your surgeon
choose the optimal implant.

Keep in mind that following the advice from a surgeon on
this or any other website who proposes to tell you what to do without examining
you, physically feeling the tissue, assessing your desired outcome, taking a
full medical history, and discussing the pros and cons of each operative
procedure would not be in your best interest. I would suggest that  your plastic surgeon be certified by the American Board of Plastic Surgery and ideally
a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you
trust and are comfortable with. You should discuss your concerns with that
surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.  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.   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? 
  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 necessary to seek several consultations before you feel comfortable about your choice.
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. I have found that the use of words such as “natural” or "D or DD cup” etc may mean 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, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.
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. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.
 I hope this helps. Best wishes for an outcome that you will be very pleased with.

Enriquillo Clime Rivera, MD - Account Suspended · Answer

Hi, and thank you for the question
  
Based on the information and photos you send us, you have a small body frame so i see no reason to used more than 450 CC. As you can understand studies and test are needed to see if you are clear for surgery but in general, if you seek the attention of a certified plastic surgeon, you should have a great result and a normal life. So feel free to contact us for further evaluation.   
  
Thank you again and have a great day

Ronald V. DeMars, MD (Retired) · Answer

You have pinpointed the exact reason we discourage patients from "trying on" implants. It does nothing but create confusion and frustration. The only thing you need to do is be examined and then show the surgeon your wish photos. It is the surgeon's job to determine what it will take to help you reach that goal. This is done by having a selection of implants available in the Operating Room, then using internal sizers during surgery to see exactly what a certain implant looks like IN you. That is very different from the look in your bra which is of practically no value. The surgeon should be making these types of decisions several times a week for year after year, you do not. Who is best suited to make that choice?

I can’t decide! 485 or 520cc and high or moderate or mod plus? (Photos)

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