Is my doctor going too big with 560cc silicone? I am a small C cup with 350cc saline implants (previous 34AA) (Photo)

Question

I am 5'5", 135lb, 21, a small C cup with 350cc Saline. Switching to silicone for the softer feel and a cup size increase to a fuller D. I want to keep a natural look but still have larger breasts. I do not want round, fake, stretched breasts. I do want full breasts with cleavage which I do not have now. The chest tattoo photo is me now, and the next two are goals (sort of).

Gary M. Horndeski, MD · Answer

Thank you for your question and helpful pictures. In order to achieve your desired "look", an implant of >500cc will be required. Before moving forward, please consider the following: heavy implants (>300cc) typically don't stay where they are placed. The photos you are showing are of women who have recently had their procedure. Please visit the breast implant revision forum on this site to see what happens to breast implants after a few years. Implants can cause irreversible soft tissue damage, skin stretch deformities, chronic pain, nipple numbness, malposition, capsular contractures, etc. Your breasts are lovely and have a very natural appearance that can be easily preserved for years to come by wearing supportive bras. Please know that the larger the implant, the heavier it will be, thus the sooner it will sag. Just want you to be well aware of the risks and complications associated with larger breast implants. I hope this information helps you make an educated decision.Best wishes and kind regards,

Daniel Barrett, MD · Answer

Dear lindsey_rusty, 
  
Determining the idea breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. 
  
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 have 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.
  
Make sure your surgeon understands your goals. 
  
Daniel Barrett, MD, MHA, MS
  
Certified, American Board of Plastic Surgery 
  
Member, Am. Society of Plastic Surgery

C. Bob Basu, MD, MPH, FACS · Answer

Thank you for posting your photos and "wish pics".  It looks like you will get a very nice result with the new gummy bear silicone gel implants.  Whether you can achieve the shape found in your wish pics will depend on your tissue quality and skin.  But you can definitely avoid your non-wish pics.  Please visit with a board certified plastic surgeon to learn more about your options. Best wishes,Dr. BasuHouston, TX

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.
You will find that online consultants will not be able to provide you with specific advice in regards to selection of specific breast implant size/profile.  There are many variables (besides breast implant size/profile) that determine the final breast shape/position after breast augmentation or revisionary breast augmentation surgery.

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, and computer imaging) will be critical.

Generally speaking, the best online advice I can give to ladies who are considering revisionary 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. I have found that the use of words such as “natural” or "D or DD cup”  Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.

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). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient.
I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.

Is my doctor going too big with 560cc silicone? I am a small C cup with 350cc saline implants (previous 34AA) (Photo)

Answers (4)

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