What is the best size Breast Implant to fit my body and lifestyle? (photos)

I choose 450cc's at my consultation but I'm worried they will be too big. I'm 5'10" tall and weight about 165lbs. My chest measures 35" under the breast and 38 1/2" across the nipple. My goal with surgery is to be 40 1/2" across the nipple. I have a bit of sagging after two kids and my PS sugguested we to a bi planner implant to correct the problem. Im not sure if that's the best course of action with My being very active at work and fitness. I'm curious to hear other doctors thoughts. Thank you

Doctor Answers 7

Best implant size

Hello,  It is hard to provide advice based on your description because a proper breast exam including measurements is required.  Generally for taller women with larger breasts, proportionately larger implants are needed to make a significant improvement in their breast shape.  However, your PS will be the best source of advice regarding the exact implant size and type.

Breast Implant Size

Thank you for your question.  I would really recommend doing a Full Breast Lift, with or without Implants.  And honestly if implants are desired I prefer doing this in two stages, as the result is far and away better.  If you were to place implants without lifting the breast, you would end up with a less than desirable look.  This is what we call "a rock in a sock". 

All the best to you



James E. Murphy, MD, FACS
Reno Plastic Surgeon
5.0 out of 5 stars 31 reviews

"Dual plane" breast augmentation is not a substitute for a breast lift

You mentioned a "bi planar" breast augmentation, by which you mean "dual plane." Actually "dual plane" is a misnomer. A dual plane is really a plane under the muscle with some additional dissection around the border of the muscle that is supposed to provide a little lift to the breast. But there is no proof of this. In fact, the evidence is to the contrary (I have an article pending publication on this point). You need a breast lift in combination with implants and 450 cc is by no means too big. The vertical breast lift is best. I call it an "all seasons augmentation/mastopexy." If you like you can read more about this and view before and after photos of this treatment combination at my website. The link is below.

Eric Swanson, MD
Kansas City Plastic Surgeon
4.7 out of 5 stars 52 reviews

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question.

From your photos, it appears that you would benefit from a breast lift as well.  A breast lift would reposition your nipples and reshape your breasts, giving them a more youthful appearance.

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

What is the best size Breast Implant to fit my body and lifestyle?

Thank you for the question and pictures.  

 Although definitive advice would require in-person evaluation, I think that it is likely that you will benefit from breast lifting as well as breast augmentation surgery.  Based on your description of "sagging" and after viewing your photographs, I would be concerned that you will not be pleased with the long-term outcome achieved with breast augmentation surgery only. 



 I do not suggest that you utilize larger breast implants (than you will feel comparable with physically or psychosocially) in the attempt to avoid the need for breast lifting. Again, consider all these concerns as well as the longevity of any procedure as you consider options.



Of course, breast augmentation/lifting surgery is a more complicated procedure (and more complication prone);  careful selection of plastic surgeon and careful communication of goals will be key.  Furthermore, you will need to carefully consider the trade-offs (such as additional scarring) associated with breast lifting versus the upsides briefly discussed above.



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 will a significantly higher risk of complications and need for additional surgery.  Again, it will be important that you educate yourself regarding the pros/cons/risks/complications associated with breast augmentation/lifting surgery. Only after doing so can you make an informed decision whether or not to proceed. You will find a lot of information on this website and on the attached link.



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 "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. 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.

Breast Augmentation - Size Selection

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.

Advice on breast augmentation

Thank you for your question and photos Lindsay!

Although it is not 100% clear, your photo seems to display ptosis (sagging) which is evident by the downward pointing nipple, and deflated breast. Your nipple may be near or below the fold under your breasts (inframammary fold), and your breast tissue is hanging mildly below the breast fold. You also seem to have a lot of lateral tissue that needs to be tightened up.

We all have different opinions and methods to correct sagging, but it would be my recommendation to that for best aesthetic results, the sagging should be fixed with a mastopexy (breast lift).

If you receive breast implants without the correction, then you will not only have to go with a larger than usual implant, but it will also appear too low on your chest (bottoming out). The weight of the implant will worsen the amount of sagging. You may also have a double bubble deformity where the breast tissue overlying the implant droops below in front of the implant. It may also cause a snoopy deformity (named after the cartoon character snoopy) that happens when the implant is held sitting in a high position by tight pectoral muscles, while the natural breast tissue falls off the implant and hangs below at the bottom curvature of your breast.

As such, you need a breast lift for best aesthetic results.

If you are afraid of scars brought on by a breast lift, you can get an initial breast augmentation, and if you become unhappy with your results, then you can definitely opt for a breast lift in the future.

That being said, a biplanar/dual plane approach can mildly correct the sagging by applying more  direct pressure at the bottom of the breast. However, in my personal opinion, I do not believe this will be enough to correct the problem.

You mentioned you want to remain active, and although the biplanar/dual plane approach does involve releasing some of the pectoralis muscle, you will still be able to remain active. You will have to avoid intensive exercise for at least 6 weeks though like all other patients.

With regards to choosing the right implant size, please know that your implant has to fit your body dimensions. The more you deviate from the proper fit, the more fake your breasts will look. Most surgeons will use what is called tissue-based planning. The planning takes into account the effects of implants on tissues over time, risks of excessive stretching, excessive thinning, visible or palpable implant edges, visible traction rippling, ptosis (Sagging), and breast tissue wasting.

To determine the implant size, breast measurements must be made: 1) Base Width of the existing breast tissue, 2) breast skin stretch, and 3) Nipple-to-Inframammary Fold distance. The combination of these measurements will help determine tissue coverage and the required implant volume to optimally fill the breasts. 

Make sure to choose a surgeon you can trust. Your surgeon should be someone who does not rush you, and someone who does not agree to everything you say because safety should be the first thing on their mind. Clearly, you wouldn’t know what is best for you, so they should guide to make decisions that will minimize complications and allow you to have beautiful breasts in the long-term.

Verify their skills, education, and certification. Ask about your surgeon’s experience about the procedure you want and ask to review photographic examples of your surgeon’s work. Check to see if the aesthetic ideal is consistent with what you are hoping to achieve. Please make sure that you look at pictures of patients who had the same pre-operative breast characteristics that you display. Also make sure the before and after images have the same perspective, the same lighting.  Read the surgeon’s reviews for the procedure you want.

Hope this helps.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 425 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.