Is 385 cc too large? (5'10", 145 lbs, 34A, 25 yo) (photos)

Question

My doctor and I decided on 385 cc's high profile silicone gel implants (under the muscle) to achieve a full C. One thing he mentioned that concerned me was that I had mild characteristics of constricted breasts. A couple questions I have: 1) Is a 385 cc high profile too big considering I have very little breast tissue? 2) Is it possible for someone with constricted breasts to obtain a natural look?

Jose M. Soler-Baillo, MD, MS · Answer

Thank you for your question.  I think that the size of the implant should be appropriate for you to achieve a good result.  However, high profile implants will give you a very "augmented" look given your starting point as compared to smaller implants or say, moderate profile implants.  Nonetheless, if you have made sure to communicate your realistic expectations clearly to a surgeon who is board-certified in plastic surgery, then I suggest you confide in his or her expert opinion.All the best,Dr. ResultsMiami, FL

Brian K. Reedy, MD · Answer

I think that as long as you and your doctor are happy with your choice, 385cc will give you a nice look.  It will be a little fuller on your petite frame, but often times, taller women can pull off having a bigger implant without looking top heavy.  I think you can absolutely obtain a natural look (even with slightly constricted breasts).  Good luck!

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.With Constricted or Tubular breasts, Improvement
is possible and generally includes a breast augmentation, sometimes combined
with a lift (mastopexy). The lift is usually limited to an incision around the
areolae. During the procedure, I release the tight, constricting bands from the
inside, allowing the skin to expand properly. I also lower the inframammary
fold to a more ideal position and improve its shape. Breast implants help
create the right amount of volume and improve breast contours, resulting in a
more rounded or tear drop shape.

The size of implant 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

Director-Beverly
Hills Breast and Body Institute

#RealSelf100Surgeon

Aldo Guerra, MD · Answer

Thanks for sharing. I believe you're choosing a pretty good sze that is in the C range and can look natural. When the lower pole is constricted then a few extra steps must be done to expand the lower pole. These can include breast vertical scoring and dual plane release. Since your plastic surgeon has examined you and did not feel 385 cc was too large then it seems like good advice. Smaller breast implants look more natural and perhaps speaking with your surgeon again about this subject is what needs to happen. Best wishes, Dr. Aldo

C. Bob Basu, MD, MPH, FACS · Answer

Dear tallgirlboobs90:Thank you for posting your photos.  It looks like you will likely get a great result from breast 
augmentation. I think you would benefit from a breast augmentation with a
 dual plane technique. If you indeed have a mildly constricted lower pole, you may need a radial release to relax any internal constriction bands to help expand the lower pole of your breasts.  Of course, a physical exam is needed to give you any formal recommendations.  In terms of picking the right implants to 
achieve your 
goals, generally speaking, I consider two  
factors when selecting implants for my patients:1. Dimensional planning2. Gel Implant Sizing systemDimensional
 planning – The measurements of your chest wall are taken. Also, the  
breast dimensions including the height, width, and current dimensions of
 each breast form the basis of dimensional planning. Based on these  
measurements, the implant size is recommended. This will give you a  
unique breast implant that is suited for your body frame. However, there
 are some limitations of what size we can recommend. For instance, some 
 implants may just be too big for a narrow chest wall. Your surgeon can 
 review this with you during the consultation.Gel Implant Sizing
  system – During the preliminary breast implant consultation, you will 
be provided with an option to “try on” a variety of implant shapes and  
sizes. You can also visualize the possible outcomes of your surgery  
which helps you to get that perfect size to give you the shape that you 
 longed for. This way your preferences are known and you can then pick a
  range of implants that will “fit” just right to give a soft natural  
fuller look. Hope this helps.Dr. BasuHouston, TX

Kamran Khoobehi, MD · Answer

It is very hard to give you best advise based on only few pictures but one thing I would recommend is smaller implants. You have very small amount of breast tissue to cover 385 cc implants. The other issue is your chest wall asymmetry. For natural look and feel I would suggest much smaller implants like 285cc.

Cain R. Linville, MD, FACS · Answer

I think your worries may be valid but I'd have to see you in person. It's going to be extremely tough to fit that implant in the pocket. I'd likely go with a shaped, mod plus profile shaped implant to give you a natural looking result and fill out the lower pole. Dual plane.

Robert Singer, MD · Answer

The interpretation of
"natural looking" varies greatly from patient to patient and from
surgeon to surgeon.The best cosmetic result in any
particular breast augmentation patient depends on a variety of factors,
including: your individual anatomy, 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. 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 sit
at a preoperative visit will help you and your surgeon choose the optimal
implant.
There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 34 C and a 38 C are significantly different. Cup size
varies from manufacturer to manufacturer and even within styles from any
particular manufacturer.
Keep in mind that following the advice from a surgeon on this or any other
website who proposes to tell you exactly 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

Forrest S. Roth, MD, FACS · Answer

385cc implants should not be a problem as long as the implant width is the same as your chest wdith.  Furthermore, you can achieve a natural look with constricted breasts if you choose an implant thats not too large and your surgeon lowers your inframammary fold, performs radial scoring, and/or dual-plane technique depending on your degree of constriction.

Brooke R. Seckel, MD, FACS (retired) · Answer

First and most important, you have e beautiful healthy body shape and you do not want to distort it.You have small slightly constricted (only on the right) breasts but basically normal shape.A properly done dual plane submuscular breast augmentation should be able to achieve a very nice result.By doing a dual plane if needed some vertical release incisions can be made on the right side to allow the implant to expand the lower pole of the right breast to more clearly match the left breast.I would choose a moderate profile plus implant that fits closely to your breast base width as this will give you more cleavage and side boob. This may require sizing down to 350ccMPP but that will give you a full C cup.Again you have an excellent body and your breasts should match. Don't go too large with a high profile-choose a moderate plus that fits your base width.Just my humble opinion based on 35 years experience.

Is 385 cc too large? (5'10", 145 lbs, 34A, 25 yo) (photos)

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