Is 745 cc too large ?

Question

I had a breast reduction done in 1998 and was taken from a 40DDD to an A cup or a very small B - I can't fit into a bra. I am 5"5 and about 190 lbs now after losing about 100 lbs. I am scheduled for a Mommy Makeover on September 28th, 2016. I went for my consultation and was measured etc. and subsequently told that my chest would accommodate 745 cc's very well and that with the tummy tuck I would have a very nice curve to my body with the extra skin removed from my tummy.

David R. Alfonso, MD, FACS · Answer

Those implant sizes sound a bit too big for virtually any patient. Assuming your skin is a bit stretched from the weight loss those implants would accelerate tissue stress Consider going smaller and tightening the skin with a mastopexy

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the best lift you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implants

Jed H. Horowitz, MD, FACS · Answer

#Breastimplants come in a variety of shapes, sizes, and profiles in order to offer a custom-fit and natural-looking physique. It is also important to consider the substance and texture of an implant. In particular, those implants approved by the U.S. Food and Drug Administration (FDA) are filled with silicone or saline. These materials impact the feel and look of a breast implant, and thus are an important consideration in determining the desired appearance of your breasts.We aim to custom-tailor breast augmentation based on patient preferences for perkiness, firmness, shape, and size. Our goal is to match the appropriate implant type with the right procedure so that you are completely satisfied. Breast #augmentation will enhance the shape of your breasts as well make them fuller. You may find yourself more comfortable wearing different types of clothing and may enjoy a boost in self-confidence, as is the case with many happy patients. Now, it is completely up to you for the final decision of your implant size, but it should be discusses with your surgeon in consultation in order to make sure that you place comfortable expectations upon your final results.

Ira H. Rex lll, MD · Answer

This question is almost impossible to answer without a good examination by a board-certified plastic surgeon. There are many variables that will determine the final aesthetic outcome, and no certain volume is the best for any given patient. Perhaps try on some sizers to determine what best fits your body and expectations.

Ryan Hoffman, MD · Answer

Without pictures and an examination that is a difficult question to answer. Just because your chest wall can accommodate a large implant doesn't mean that is your desired look. Discuss your concerns with your surgeon and if you still are uncomfortable seeing a second surgeon for another opinion may help. Good luck with your surgery!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.   The size of the implant is based on your desired
breast size/shape, your chest wall measurements, and soft tissue
quality.  This decision should be based on a detailed discussion
with equal input from both you and your surgeon.  
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The size of implant best for you 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

#RealSelf100Surgeon

#RealSelfCORESurgeon

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

N. Bill Aydin, MD · Answer

Hi, Thank you for your question. A 745cc implant is a large implant. It is hard to say without seeing you how large the implant will look. I would advise you to set up a time with your surgeon to go and try on sizes.  Bring a tank top and one of your regular shirts to see how it will look on you.

Vincent N. Zubowicz, MD · Answer

745 mL breast implants are large on average but not necessarily too big for you. There good sizing systems available that can give you a good idea what to expect from this size implant.

Is 745 cc too large ?

Answers (15)