Is 745 cc too large ?

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.

Doctor Answers 16

Is 745cc too large?

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

Is 745 cc too large ?

Thank you for the question  and congratulations on your significant weight loss. 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.  

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” 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. 

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 "larger" breast augmentation surgery concerns), helps. Best wishes.

Implant Size for Breast Augmentation

#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. 

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 94 reviews

That is Too Large

People who follow me here know that I do not mince my words and I go straight to the point. I believe you would be best served with an implant between 350 to 500 cc and sizers need to be tried in surgery before the final decision is made. 745 is way too large, especially considering the fact that you plan to carry them for a long time. The weight alone would bother you ( do you remember the problems you were having with large breasts? )

Ahmet R. Karaca, MD
Birmingham Plastic Surgeon
4.9 out of 5 stars 9 reviews

Choosing a breast implant after major weight loss

Thank you for asking about your breast augmentation and tummy tuck.
  • This is a large implant -  it will be heavy and might take you back to a DD or higher.
  • That doesn't mean it is wrong.
  • Choosing the right implant is very complex -
  • But without an examination and discussion of the pros/cons, one can't tell you what is right for you.
  • My attached video on finding the right implant may help
  • You should definitely see your surgeon a second time before surgery to discuss this and consider a second opinion for peace of mind.
Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

Is 745 cc too large ?

It is difficult to answer that question but 745 mL is an extremely large implant.  Current implants in this country do not exceed 800 mL just for your information.
Larger implants do have a high risk of complications of think carefully before making a decision and consider mastopexy for skin reduction to better balance excess skin with a more reasonable volume.  Without seeing you in person of course I am just "guessing" but if you have concerns and are in certain to seek a second opinion. Best wishes.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 29 reviews

What size of breast implants

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.

Ira H. Rex lll, MD
Fall River Plastic Surgeon
4.6 out of 5 stars 43 reviews

Is 745 ccs to large

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!

Ryan Hoffman, MD
Philadelphia Plastic Surgeon
5.0 out of 5 stars 27 reviews

Implant size

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

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 67 reviews

Implant size

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 

David R. Alfonso, MD, FACS
Grand Rapids Plastic Surgeon
4.9 out of 5 stars 34 reviews

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.