Is there a big difference between 545 cc and 560 cc gummy bear implants and sagging long term?

Question

I’m having a breast implant revision this week and I’m having a hard time deciding between 545 cc and 560 cc gummy bear implants. I did have 385 cc and a lift before but afterwards I ended up with smaller breasts than I started with so I’m having this revision to achieve my fuller breasts again. I am worried the 560 will make me sag sooner. I was told over 550 the chance of sagging is worse. Is this true? Is there a big difference between the 2 sizes anyways?

Miguel Delgado, MD · Answer

15 cc's is very little difference and doubtful if noticeable as 15 cc's is about a tablespoon, but both are large implants. Discuss with your board certified plastic surgeon your concerns about sagging. Good luck.

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for your question.    A 15cc difference is minimal and will not make a significant difference in breast sagging.  I would recommend that you address any further questions with your plastic surgeon before your surgery date.  Be sure your surgeon addresses all your concerns and discusses the surgery details including the position and size of the incision used, all the type of breast implants available, the risks and benefits of the procedure, recovery time, and post-operative course.  Also, be sure to see plenty of before-and-after pictures in women who have a similar breast appearance to yours, and preferably at different time frames (3 weeks out, 3 months out, etc) to more accurately predict your own surgical outcome. 
  
And lastly, I think the most important component of the consultation is to establish a good connection with your plastic surgeon.  It’s the connection that allows you to clearly define your desired breast outcome goals, the first step of this whole process. If you don’t feel you have a good connection with your plastic surgeon after your consultation, he/she may not be the best surgeon for you.  
  
For more information on breast augmentation, please refer to my link below.
  
Good luck.  
  
Mark K Markarian, MD, MSPH, FACS 
  
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Miguel Mota, MD · Answer

Hello, That is an excellent question. Implant weight can affect sagging, but the difference between these two implants is minimal. You will probably get great results with whichever you choose. When you were told that going over 550cc might increase the rate of sagging, the surgeon was probably stating that as a comparison with the 385cc you already have. Meaning, that 200cc over what you already have, will make them heavier and this might lead to more sagging in the future. But choosing one or the other (between 545cc and 560cc) will not make a difference.Best of Luck,Dr. Mota

Ted Eisenberg, DO, FACOS, FAACS · Answer

15 cc is equivalent to one tablespoon- a very small difference in implant size. The 2 main events that could possibly change your surgical results and cause sagging would be significant personal body weight change and/or the milk of pregnancy, not the implant size.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author RealSelf Distinguished Hall of Fame Inductee

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation. The difference between 545 and 560cc is extremely small.  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.  FACS

Harvard-trained plastic surgeon

William L. Reno, III, MD · Answer

The difference between the two implants is so small it will make no difference in the long term results of the procedure.

Daniel Barrett, MD · Answer

Dear Sociable4788,
15cc is not much in terms of increasing weight of implants. However, 560cc implants are big and heavy and may cause sagging with time. 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

Donovan Rosas, MD · Answer

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.The key to obtaining a natural result is to stay within the parameters defined by your BWD. 
With regards to your specific question, I discourage patients from struggling over such a small volume differential. 15 cc is roughly equivalent to 3 teaspoons and is unlikely to make a significant difference in outcome. Greater volume  greater weight with complication rates rising above 400 cc. That being said, there is likely very little difference between your 2 chosen options.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

John L. Burns Jr., MD · Answer

You can visualize the difference between volumes using 3D imaging technology.  The 15cc difference between the two implants is less than a teaspoon.

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  In the size ranges that you are describing there would be little difference in long-term results and sagging between a 560 and 545cc implant.  Hope this helps.

Is there a big difference between 545 cc and 560 cc gummy bear implants and sagging long term?

Answers (17)

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