Will my 450cc Moderate Plus Silicone Implants be too top heavy & saggy on my body? (photos)

Before I had children I was big chested and would like that same look back! I just don't want to go too big! I am 5'7, 120lbs, BWD 14cm. Would 450cc moderate plus be to big, under muscle, inframammary incision. Since I have had two pregnancies with extended nursing on both would my implant look saggy?

Doctor Answers 14

Implant Too Top Heavy?

You are fairly tall at 5'7" with a normal chest width, so a larger implant on you would not look as big as the same sized implant on a shorter person. A 450cc implant is not a huge implant and I think from you photos will give you a balanced look. You are starting with a normal breast shape and with a properly placed 450cc moderate plus implant you should not look too top heavy. Having said that, there is not any one size that is perfect for each patient, but there is a range of sizes that will give you a balanced not overly augmented look. I think that the 450cc implant is towards the upper end of that range, but should still be fine for you.

Implant size

A proper evaluation and measurements is required, but i do think 450 cc will be bigger than your wish pic. 
I would also consider a high profile implant, dual plane, inframammary incision.

Best of Luck,

Dr. Luis Redondo

Luis Eduardo Redondo, MD
Dominican Republic Plastic Surgeon
5.0 out of 5 stars 17 reviews

450cc implants

I like the base of the implant to closely match the base of the breast. This allows for a more natural look so the implant does not stick out beyond the edge of the breast. I typically like sub-muscular implants and in infra-mammary incision. This again allows for a more natural look.
One however needs to be somewhat concerned about large heavy implants. Gravity works and the chest wall and abdominal wall are in one continuous plane. If the muscle is completely taken down and or the breast crease is adjusted to allow for the large implant then the natural 'breast shelf' has been disturbed and the possibility of implant migration, downward, exists. This is called "bottoming out". With bottoming out the nipple will be above the center of the implant as it continues to migrate downward.
One also needs to understand that data shows that when implants are greater than 350cc is size / weight complications rates increase. Your doctor should present you with a separate consent form for larger implants so you understand your increased risks.
The final component one needs to consider is the skin. The skin envelope covers everything that has been carried out below, implant placement. If the skin is damaged from pregnancies, breast feeding, weight gain / loss etc., then this may also increase your risk of implant shifting afterwards. You now may require 'touch-up' surgeries to improve implant position.
I hope this helps.


Your breasts would definitely be larger with a 450cc implant. They would be significantly larger than the photo with the bikini that you show. You should get a good lift effect from the implant as well. It appears you have some natural degree of synmastia/cleavage.  A surgeon would need to be careful to make sure the implants are not too close together in your situation. 

Shim Ching, MD
Honolulu Plastic Surgeon
4.6 out of 5 stars 40 reviews

Choosing implants

Your best bet when you are trying to decide on implants is to try on sizers of the exact implant you are considering inside a very tight sports bra. This will give you a close idea of what you will look like. More importantly the dimensions or width of the implants need to match and fit your frame and body. If you are working with a board certified plastic surgeon with an expertise in breast augmentation he or she should be able to help you with this in their office. Good luck! best, Dean Vistnes, M.D

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
5.0 out of 5 stars 40 reviews

Will my 450cc Moderate Plus Silicone Implants be too top heavy & saggy on my body?

Thank you for your question.  You have excellent naturally shaped symmetrical breasts and are an ideal candidate for a sub-muscular breast augmentation mammoplasty.

Of course it is most important that you follow the specific advice of the plastic surgeon who will be performing your surgery.  That said a base width of 14 can accommodate a 450 cc breast implant.

You are tall and the fullness and cleavage that you show in your pre-pregnancy breast  will require an implant most likely in the 400-450 cc range. If you are concerned about being too top-heavy the 350-400 cc implant should give you a very nice full result and might be a better choice because you are concerned.

For more information on choosing breast implant size please read the following link:

Right size implant after babies

You are tall and very thin but your breast skin looks as though it will accommodate a 450 implant-
because of your original size and having had 2 children.

To see if a 450 size will look right on you, you have to try on a sizer and others ones larger and smaller, e.g. a 400 and a 500 to be sure you like the look.

Best wishes.

You definitely need to be careful.

It requires a full evaluation to know what will look good and give a lasting improvement in volume. There are a lot of measurements and portions of the examination that go into making a precise recommendation on final implant volume.

As always, you need a Board Certified Plastic Surgeon who is experienced in breast augmentation to help you look at realistic options for increasing your volume. It may not be possible to achieve the size that you desire without significant negative effects on your body.

With a thorough exam and measurements, your Plastic Surgeon will have a much better idea of what volume of implant to suggest. Remember a size 6 foot rarely works well in a size 2 shoe.

Based on your photos, you seem to be at risk for two problems you really should discuss with your P.S.:  bottoming out and symmastia.

Will my 450cc Moderate Plus Silicone Implants be too top heavy & saggy on my body?

Thank you for the question and pictures.  You are starting at a good place and should have a very nice outcome with breast augmentation surgery. As you consider breast augmentation surgery, the most important decision you make is NOT size/profile of breast implant, but selection of plastic surgeon. 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.

 2.  Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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 "C or D cup" or "too big" etc means different things to different people and therefore prove unhelpful.

 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.   Therefore, I ask that my patients not base their communication preoperatively OR  their satisfaction with the outcome of surgery postoperatively, on achieving a specific cup size. The use of computer imaging may be very helpful during this communication phase.

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.  The use of temporary intraoperative sizers, viewing the patient's breasts in the upright and supine position, are very helpful during the breast implant selection process.

I hope this, and the attached link (dedicated to breast augmentation surgery concerns), helps.  Best wishes.

Implant Size To achieve your goals

Generally speaking, I consider two factors when selecting implants for my patients:

1. Dimensional planning
2. Gel Implant Sizing system

Dimensional 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. Basu
Houston, TX

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.