Size concerns. Surgeon suggested 300-320 cc high profile. Isn't that on the more modest side? (Photo)

Question

I had my consultation today with for a breast lift &implant. I am very small (very short and thin but with plenty of breast tissue) and the surgeon suggested 300-320 ccs high profile. I explained a few times that I like the slightly augmented look and he said that around 300 would be good. I know the ccs all depend on the person but from what I have seen I thought he would suggest around 400? Isnt 300-320 on the more modest side? Should I trust his recommendation to achieve the look I'm after?

Sheila S. Nazarian, MD · Answer

Choosing the right size implant depends on any number of factors and requires an in person exam. Why don't you "try out" the 300-320  and 400cc with either gel inserts or the at home rice method (1 oz rice = 30cc breast volume, put in ziplock bags, put in bra) and see which you prefer. Best, Dr. Nazarian

Thomas A. Mustoe, MD, FACS · Answer

Firm recommendations on implant size can only be made with the benefit of an in person examination. The most important thing you can do is choose your surgeon carefully, and then trust their recommendations. You have considerable breast tissue already, and I think it is quite likely that in a thin short patient like yourself that you would be achieve your desired look with a 300cc implant.  A breast lift combined with implant is a much more complex procedure than either by itself, and in women who already have a lot of breast tissue, large implants are not necessary to achieve a very full look.

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 350 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. . 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 a bit.

Tania Medina de Garcia, MD · Answer

Hello dear, thanks for your question and provided information as well... The breasts may lose their elasticity and firmness which can be caused
by different factors such as pregnancy, massive weight loss, lactation and
aging. To reaffirm the breasts and restore the natural look your surgeon can
perform a mastopexy or breast lift with augmentation such as silicone implants,
you will get very nice results, contact a board certified plastic surgeon, I suggest you to get from 300 to 350 high profile implants, soft cohesive...hugs!

Andrew T. Cohen, MD, FACS · Answer

Determining breast size can take time.  I use sizers in the office to determine what will look best. Look for a board certified plastic surgeon. Good luck!Andrew Cohen MD

Mark T. Boschert, MD · Answer

You should be a very big part of choosing the implant. I hope that you were able to try some on, I think that is a very effective method to helping you decide the volume. As far as the choice of implant if you were going for the very round shape I would also look at the new Inspira line made by Allergan.  You said that he had suggested style 20, that is also made by Allergan so I know your surgeon would have access to the newer higher fill ratio (Inspira) implants which may help give you a slightly more rounded look.Good luck!

Tom J. Pousti, MD · Answer

Thank you for the question.  Online consultants will not be able to provide you with very specific advice regarding breast implant size and/or ultimate breast size achieved.

Ultimately, careful measurements, dimensional planning, and careful communication will be key.

Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery.

Also, patients undergoing the combination breast augmentation/lifting surgery should understand that there are limits as to how large of an outcome can be achieved, given that breast lifting surgery does involve breast skin removal.  On the one hand, breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope. These 2 forces are counteracting each other. Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications.

Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting 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 "modest" 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. 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 with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.

I hope this, and the attached link, helps. Best wishes.

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for your question and size is an individual decision made after a complete examination with measurements and putting sizers in a bra to see what volume you like on your chestDr Corbin

Size concerns. Surgeon suggested 300-320 cc high profile. Isn't that on the more modest side? (Photo)

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