I had a Breast augmentation, 32B to a 32D with 300 cc's. They just aren't quite the size and fullness I wanted. Advice? (photo)

Question

I'm considering getting them redone but if I do I want to make certain I'm getting exactly the size I want. I'm just having such a hard time figuring out what cc's I need. Could someone PLEASE give me an estimate on what size silicone implants I would need to get the desired look I want? Similar to the picture posted (a little smaller would be ok too) I don't want to look like a cartoon but I want fullness. You would help me so much!

James F. Boynton, MD, FACS · Answer

Thank you for your question.  It is impossible to just "give you a number" on what size breast implant may work for you without seeing you in person, examining your tissues and taking a number of measurements on your frame. What a 300 cc implant looks like on one patient may be very different on another patient depending on the width of their chest, the rib cage, any pre-exisitng breast asymmetries, the size and density of their native breast tissue, etc.  I do not believe a patient should be "shopping for a number" as far as breast implant size for these reasons.  If you have already had breast augmentation and you want to be fuller, then that does require a larger implant typically.  In general, if you add 100 ccs to your current implant size (i.e. go up to a 400 cc implant), that may add a half a cup size or so to your current amount of fullness. The trade-off is that you also have more risks with larger implants when they get over 400 ccs.  Breast implants over 400 ccs are larger and heavier and wider. Larger implants can "bottom out" more commonly and lead to malposition.  The larger the implant, the more narrow the distance can become between the breasts. Not everyone has "enough space" to accommodate a larger implant even if they want one.  There simply may not be "enough space".  Sometimes, we change to a high profile style implant that allows more projection to the breasts while limiting the width or base width of the implant.  Finally, some patients can be in a borderline area that may need a breast lift and simply tightening and lifting the breast over the implant they have can improve the shape and fullness without even changing the implant.  I routinely see all of these scenarios.  My recommendation is to visit with one or several board certified plastic surgeons in your area that specialize in aesthetic breast surgery.  I hope this helps!

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

It is very difficult to determine 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 400 cc implant to make her go from a “B” cup to a “D” cup size does not mean that you will have the same result with the same size implant. . 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 below link:#BtoDImplantSize

Sheila S. Nazarian, MD · Answer

I so wish that this is something that I could help you with online, but it's not. It requires an in person exam. If you are unhappy with your results then speak with your surgeon and if you no longer trust him or her then schedule a consultation for a second opinion with another board certified plastic surgeon in your area (link below). Best, Dr. Nazarian

M. Scott Haydon, MD · Answer

Thanks for your question and the photo. Keep in mind that the photo you are showing has no details (age of patient, number of pregnancies, presence of implants, size of implants, etc.) If you can somehow locate a patient that has a similar shape and volume that you did prior to your surgery and the resulting look you like after, then you and your surgeon will more easily be able to communicate. Best of Luck!

Arthur Dean Jabs, MD, PhD, FACS · Answer

The question is impossible to answer without an exam and taking some time to understand what it is you desire. A single picture and the desire to "get exactly what I want" are not enough. Measurements and possibly and imaging session along with a discussion to better understand what you are looking for will help. It is not a one size fits all sort of thing. Every patient is individual with different needs. Take some time to see a few surgeons and find someone whom you trust.All the Best,Dr. JA. Dean Jabs M.D. Ph.D. FACSBoard Certified Plastic SurgeonBethesda MD/McLean VA

Jed H. Horowitz, MD, FACS · Answer

In my experience in general, if a woman wears a
size 36 AB bra and would like to be a C cup, which is the average size that
women wear and the average size bra that is sold, she needs a volume of
approximately 350 to 390 cc to make that change. This becomes less if she's
wearing a 34 bra, because it has a smaller strap size and the cups have a
smaller diameter. A smaller diameter implant would then be a volume of
approximately 300 to 350 cc. In the same way if she was more petite, maybe a
double zero or size one and wore a 32 AB bra, then to become a 32C cup she
would only require about 250 to 300 cc.

Michael M. Omidi, MD, FACS · Answer

Thank you for the question and photos.  As
I stress with most patients, the choosing of implants is a very crucial and is
one that should be done through an in-person exam.  Various aspects could
affect the choice of implants like breast tissue, body measurements, desired end
result and the like.  Bra sizes also differ from one manufacturer to
another so a carefully selected implant can be able to get you very close to
that size.  Best to visit a board-certified plastic surgeon and give him and exact idea of what end result you want to have.  Don't be shy. Best of luck. Dr. Michael Omidi.

An in-person exam with a board-certified plastic
surgeon is the best way to assess your needs and provide true medical advice.

Mike E. Gonce, MD · Answer

Thanks for your question!  Voice your concerns with your surgeon.  Timing is important, especially when wanting to go larger, because you want to make sure you are healed from the first surgery.  It's not uncommon to go with at least 100cc's or more when changing size to be able to notice a difference.  The bigger you go, the more fullness up top you'll get, but there is also a limit as to what will fit. Again, talk with your surgeon, show him/her photos of what you like, and hopefully you can get exactly what you want.  Best of Luck!

Peter E. Johnson, MD · Answer

Very careful communication is key to reaching the look you want after augmentation. We work with trial bras and implants as well as photos, and examination of current size and available breast tissue to determine the size shape and position of the implant. The picture of what you wish to look like is a good start but you will have to start the discussion with your surgeon in person.

Wesley T. Myers, MD · Answer

Thank you for your question. Breast augmentation surgery is
individualized to each patient. The shape and size of your breasts prior to
surgery influences the final results. I tell all of my patients “Dimensions and
proportions are the determinants of a beautiful breast; not volume.” I
recommend that you make an appointment with your plastic surgeon to discuss
your disappointment and to discuss further treatment options.

I had a Breast augmentation, 32B to a 32D with 300 cc's. They just aren't quite the size and fullness I wanted. Advice? (photo)

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