A Fitness Model Torn Between 371 Cc and 450 Cc

I think you need some direct advice:  Reality is not all of your wish list is likely to be achievable.  If you're lean, you might well look fake.  The coverage over the implants is the key determinant of naturalness of appearance.

To assist you:  Decide how important naturalness is for you vs how important size is for you.

If you need to be more natural, go for the smaller size.  If looking implanted doesn't matter for what you do, then reading between the lines it sounds like you probably want to go bigger.

Final advice: the smaller size you're considering will look great, don't feel that it's a small implant, it's not.

Provided you have a breast width (base diameter) that will accept either of these implants, you have a decision to make.

If you are an athletic 5'6", 120 lb and you want to be a DD, then they will look fake if you go with the 450 cc. It would be hard to go to a double D and not look fake given your level of fitness. You must also take into account that you are adding this volume to an already C cup breast. If you have hips, then maybe you can easily accept the larger implant in proportion with the rest of your body.  If you have narrow hips, then maybe not.

The other thing to consider is the percent body fat you are during competition.  If your percent body fat is low during these times, the chance that your implants will have visible rippling increases. Large implants tend to ripple more long term than smaller ones because the heaviness can cause tissue thinning over time.

If you go under the muscle to decrease the chance of rippling, then the chance that your breast will deform and distort from muscle contractions during competitions must be taken into consideration.

At the end of the day, do you want to be big? Or do you want to be discrete? What does your surgeon say? You could choose something in between.

Breast implant size and volume is based on your breast and chest wall measurements. If your anatomy can accomodate both, go with the bigger ones. Most women say I wish I would've gone bigger NOT smaller.  Realistically, there is only a 79cc difference in volume which is less than 1/2 cup size! Good luck.

The most important determination for choosing a size is the base diameter of the breast, which I presume your surgeon measured and told you that either of the sizes will fit. In general, the high profile implant will have more of the fake round look that you specifically said you don't want. The bigger implants are also more likely to sag and stretch the skin over time. Be very certain you are aware also of how placement of the implants under or over the muscle will affect your fitness activies and appearance in competitions. Under is more prone to animation deformities which are distortions when you flex, but over is likely to look more fake.

It is very difficult to determine which implant is best for you, but in my opinion I think the Allergan style 20 high profile implant is the best device. Based on your height and weight I would think an implant around 425 would be perfect. Remember, this is my opinion based only on your height and weight and my experience with my patients.  The style 20 implant provides for more upper pole fullness and stll maintains a natural look for most patients. Good luck! Work closely with your surgeon to find the right implant for you.

It is hard to give accurate information without pictures or an exam.   Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.

The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.

I wish you a safe recovery and fantastic result.

Dr. Gill

In general I use HP implants for patients that are narrow and want large implants.  Larger volume implants are obviously heavier and can lead to earlier skin fatigue.

I regularly perform breast augmentation surgery for patients who participate in body building, fitness and figure competitions. While many are initially concerned about sub-pectoral placement and the potential for distortion of the appearance of augmented breasts when the pec major contracts, I am absolutely confident that the aesthetic outcome for these patients will be far superior with implants placed under the muscle.

A pre-pectoral implant in a slender patient, especially one with well-developed muscles, looks just as you imagine it would: like a foreign object, not like a natural-appearing breast. The muscle does not have to contract for a pre-pectoral implant to look unnatural in this group of patients - it looks unnatural every minute of the day.

Achieving the ideal aesthetic position for a sub-pectoral implant requires release of part of the inferior origin of the muscle from the chest wall. I perform the minimal release of the origin of the pec major that is required to get the implant in an ideal position vertically, but also weaken the origin in the area where muscle contraction tends to displace an implant. As a result the vast majority of patients have little to no distortion of their breast appearance when the pec major muscles are tensed. Patients also do not experience any loss of function, strength or range of motion from release of this very limited part of the pec major origin. Many patients have indicated that their natural (but augmented) breast appearance has provided a significant advantage for them in competitions.

 

There is no right or wrong answer to what size you should pick. The final choice is of course entirely up to you and your preferences and tastes. Having said that, there are some considerations that you should be aware of. The larger the implant the more like an implant and the less natural the appearance becomes. By definition the most natural looking breast is one that has no implant. If you have an adequate amount of breast tissue over the implant then you can increase the implant size without looking “fake”.  In my opinion, the silicone implants give a more natural appearance even at slightly larger sizes. Since you become very thin/lean at the time of a competition then you may consider placing the implant under the pectoralis major muscle. This will provide additional “padding” or coverage over the implant and lessen the implant look. Long term you also have to consider the implications of the size and weight of the implant. The larger the implant, the more the tissues are stretched to cover the implant and the more weight that those tissue have to support. Thinner tissues have a lessened ability to support weight than thicker tissues have. Consequently, a larger implant is more likely to stretch the tissues of the breast, increase the likelihood of sag and increase the likelihood of a poorer cosmetic result as time goes on. Unfortunately, no one can determine exactly at what size these problems may occur for any particular individual. That depends upon implant size/weight, individual tissue characteristics, tissue thickness, previous stretching of breast tissues either from pregnancy and/or weight gain and also how conscientious a woman is about wearing a bra for support. All these factors and other play a role in determining what the long term results will be for any particular individual.

The reality is that the difference between a 371cc and 450cc implants is 79cc. On a percentage basis that amounts to a difference of only 17% in size between these two implants. This is a relatively small difference that would not even amount to a 1/2 cup size change in visible breast volume increase. As a general rule, really visible breast size differences require 30% or more increases. I would go with the 450cc high profile because many women regret not going big enough and the diameter of the high profile implant would be better for a smaller body frame.