Is There Much Difference Between a D and DD and What Will Look Most Natural on Me Using Round Implants? (photo)

1. Most of my patients want to go to a full C/ small D cup.  That seems to be what I hear the most.  Whenever someone wants to venture into larger cup sizes, I remind them that they are adding a lot of weight to their chests.  I get breast reduction patients who don't care what scars I put on their breasts.  They are just happy to be relieved of that weight that pulls through their neck and shoulders.  Just something to consider. 

2. Bra manufacturers do not have standard cup sizes.  With that in mind, it is hard to tell you exactly what the difference would be between a D cup and a DD cup volume-wise.  It all depends on where you buy your bras.

3. My dad used to tell me that his rule of thumb was that a cup size was roughly 150 - 200 cc's.  With that in mind, the addition of 375 - 400 cc's would probably be about right if you want to go from a B to a D cup.  I am not a big fan of textured implants but that is just personal preference.  Every doctor has his/her own preference concerning which type implants they like.

At size 32 or 34 each 100 cc’s of implant corresponds to 1 cup size change.  If you are a 32 B and want to go to a D you would require 200 cc implants.  If you want to go to a DD you would require 300 cc implants.  I recommend silicone gel implants placed retro-pectoral since they look and feel more natural, are more stable long term, less likely to ripple or have complications needing revision.  Textured implants are certainly as good or if not better than smooth since they do not migrate.  I also recommend round implants because the anatomical ones can rotate and lead to complications.



Best Wishes,

 

Gary Horndeski, M.D.

Hi,


Although it may seem easy to volumetrically tell you the difference between D and DD- it's not easy!  approximately 100-200cc.  My recommendation is go 350-375 and don't use textured unless you need to!  Best wishes!!

Thanks for your questions.  I'm a fan of using external sizers to help you decide on what size to get.  I find it difficult to believe that your surgeon can make your results more natural using an implant just 25 cc's smaller.  Regardless, with sizers, you can SEE what you will look like volume-wise.  Then your surgeon must select the style.

As for style, if you are in that photo, you don't have much native breast tissue and you can anticipate ripples being appreciable in some way or form.  If you really want to minimize rippling but are willing to accept the downside of textured anatomic implants, then you should go for the textured anatomic implants as they rarely ripple.  But they don't move much when you lay down.

You seem to have a petit chest wall based on the photos. Natrelle high profile implants like 20-400 would likely give you a great result and natural look. Larger implants will give push you the the unnatural side. I don't like to use textured implants unless someone is a candidate for anatomic implants. You would have a small 1 in incision for a smooth versus 2 inches or more for a textured. Your best scenerio would be to see a surgeon who can do Vectra 3D simulation for you to see the different sizes on you before surgery. I have had patients have a Skype consult from the UK, schedule surgery and visit New York to have surgery. After having Vectra analysis, size is finalized and you have surgery and stay in NY for 1 week. Best of luck. 

The result is more dependent upon the amount of tissue present. To obtain a DD you would look "unnatural" in my opinion. Plus to even get to a d you would need at leasts a 500 cc implant, again in my over the internet opinion. 

A D or DD is very large for your frame and if you want to look natural then stick with the D.  375 to 400 will only make you a small D.  Choosing the right implant is based upon your frame and base width of your breast.  You cannot exceed the base width of your breast or risk the problem of symmastia.  The larger you go the more your breast tissues will thin and the greater the chance for rippling to develop.  Textured implants will ripple more than their smooth counter parts.  The benefits of textured implants are lower capsule contracture rates.  If you wish not to have rippling then don't go as large and chose an implant which is more filled.  Different implant brands have different fill rates.  The Sientra textured implants are more filled than the Natrelle textured.   This is more important for what I refer to as vertical rippling.  If you hold up an implant vertically the less filled implant will display vertical ripples which can be seen in patients that are very thin.  This is not as much of an issue unless you go very large.  With the smooth implants the Mentor HP and MP+ tend to be more filled than the Natrelle similar style 15 and 20.