Picking the right implant to achieve your goals
Implant size selection is the most common question for breast
augmentation patients. In terms of picking the right implants to
achieve your goals,
generally speaking, I consider two factors when selecting implants for
1. Dimensional planning
and 2. Gel Implant Sizing system
Dimensional planning – The measurements of your chest wall are taken.
Also, the breast dimensions including the height, width, and current
dimensions of each breast form the basis of dimensional planning. Based
on these measurements, the implant size is recommended. This will give
you a unique breast implant that is suited for your body frame. However,
there are some limitations of what size we can recommend. For instance,
some implants may just be too big for a narrow chest wall. Hence a
physical exam is really needed to give you any meaningful advice.
Gel Implant Sizing system – During the preliminary breast implant
consultation, you will be provided with an option to “try on” a variety
of implant shapes and sizes. You can also visualize the possible
outcomes of your surgery which helps you to get that perfect size to
give you the shape that you longed for. This way your preferences are
known and you can then pick a range of implants that will “fit” just
right to give a soft natural fuller look. Hope this helps.
34C Wishing to Be 34 DD or E
Keep in mind that the breast skin envelope will be irreparably stretched when augmented to this size. Given your breast size currently, either of these implants would likely increase your cup size by about two sizes. I generally use an objective system to see if an implant will give a full natural breast without excessive upper pole roundness. This takes into account breast width, skin laxity, distance from nipple to fold and existing amount of breast tissue. Most women with average width chest and breasts will go from an A to a C cup with an implant in the 300 to 375 range. If you are already a C cup, each 200 cc approximately will make you go up one cup size, so either of these sizes could meet your goals. You can use a sizing bra and try on the implants, and you can also do computer imaging to see how you would look. We use the Crisalix system and virtual reality goggles so the patient can see the actual size on her body.
When deciding on implant size
its important to be able to visualize what it will look like on your frame. External sizers work well. Whatever size you like used in an unlined bra, add 10% and you have your implant size. Its never failed my patients when asked what they thought about what they saw versus what they received. In the end, you are considering implants adjacent in size to each other. Choose the surgeon you like better or who has a better reputation with his/her patients. Or decide if you were to be too big or to small, what would you prefer? If too big, then the larger one.
Without an exam or at least photos I can not make an accurate recommendation. If you could repost with at least photos that would be better. Best of luck to you!
The implant sizes are standard for all countries. There is not much difference between the two sizes, so choose the larger size if your surgeon thinks that size will work with your frame and tissue.
34 C cup to a 34 double D cup implant size?
Without seeing you in person, reviewing photographs and having a sense of the distensability of your breast tissue, it is impossible to make a recommendation. In general however those sizes sound somewhat conservative but the best determination is allowing your surgeon to choose the final implant based on placement of sizers or test implants into the pocket during the surgical procedure. At that point I feel the best and most accurate determination can be made as to which implant provides optimal shaping and contour within your desired size goal. There is no accurate way on the table other than through visualization and estimation to determine your actual cup size so showing the surgeon photographic examples of your goal may be of help. 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
I am 34 C and I would like to be 34 DD or E; I have seen two surgeons. What size should I go?
Thank you for your question. **It's important to remember that a 40 cc difference between the two implants is relatively small. It's about 3 tablespoons of volume. Also, the volume should be standardized between various countries. However, some countries have availability of different implant manufacturers.The most important factor when sizing implants, is working closely with your surgeon in person to find the implant size that gives you the look that you desire. Careful measurements of your breast and chest wall will help determine which size implants will fit within your natural breast footprint. Taking into account your desired look, and your measurements, an implant is chosen that specifically fits your body.
Unfortunately, online recommendations are not that helpful. Make sure that you have a good relationship with your plastic surgeon, so that you two can work together to find the right size.
In my office, patients try on implants in a bra and clothing. There able to see how they look in the mirror, and in photographs. Women are also encouraged to bring in wish pictures, so that I can get a sense of the look that they would like to achieve.
Good luck with the process!
What size should you go to?
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
Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery
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!
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
Best breast implants for me?
Thank you for the question. There is no accurate/reliable/predictable correlation between size/profile breast implant utilized and cup size achieved. 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 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 "DD or E cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
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.
I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes.