425cc moderate plus silicone implant? For a full DD cup? (Photos)

Hello,Before making decisions about what you think you may want, you should visit a few ABPS certified/ASAPS member surgeons expert in all types of cosmetic breast surgery. You should know that there is no way to guarantee or estimate cup size based on implant volume. It's really not a good way of deciding your aesthetic goal anyway.  Additionally, subjective terms like 'obvious or overly big' may mean one thing to you, and another to a surgeon. Instead, focus on how you'll look in the mirror with sizers. This will give the surgeon the best information possible about your goals. Best of luck.

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!

Dr. Schwartz

Board
Certified Plastic Surgeon

Director-Beverly
Hills Breast and Body Institute

#RealSelf100Surgeon

Thank you for your pictures and your questions. This is a very common question on RealSelf and you are likely to get a large number of the standard canned responses from the heavy hitters on here. Let me see if I can offer you some specific advice for your case. The implant that is right for you depends on not only your measurements but also your desires. One thing I would caution you about is the size choice you are making. If you are truly currently a 34D and you want to be a DD cup, then that would be a one cup size transition. Although cup sizing is not exact, I usually advise patients that about 150-200cc is roughly one cup size, so at 425cc, you are looking to go up by between 2-3 cup sizes. This is going to put you at around a 34E or perhaps even larger. Now if this is the look you are going for, then I think this could possibly be a reasonable choice for you and I think that based on your pictures, you stand to have good results from augmentation. Just make sure that you choose an implant that is not wider than you base width and make sure that you understand the change in size. It would be advisable at your consultation to try on the size you are considering and see if this is what you are ready for. I would also advise you to check some of your expectations and your decisions and be open to the discussion of what would work best for you in the hands of your chosen board certified plastic surgeon. Trust in his or her expertise and consider multiple consultations before making your decision.Best of luck!

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.

and its hoped your surgeon has allowed you to visualize what your outcome will be with the use of external sizers or 3D imaging.  Implants are only guaranteed to make your fuller/larger.  And since you've chosen above the muscle, you've also accepted the greater risks for ripping and capsular contractures, not to mention the potential for the rock in the sock look down the road. 

The best cosmetic result in any
particular breast augmentation patient depends on a variety of factors,
including: your individual anatomy, realistic expectations, a thorough
discussion with the plastic surgeon about the options, and an understanding of
the pros and cons of any particular implant choice. Proper sizing is not just
about the number of cc’s. The thickness of your tissue, breast dimensions which
include the width, height, and projection, as well as chest wall width all need
to be considered when choosing an implant. Trying on implant “sizers” of
various shapes and volumes while wearing a tight t-shirt, bra, or bathing sit
at a preoperative visit will help you and your surgeon choose the optimal
implant.
There are no manufacturers' standards for cup sizing in the bra industry. The
cups of a 34 DD and a 38 DD are significantly different. Cup size
varies from manufacturer to manufacturer and even within styles from any
particular manufacturer. There is no direct correlation between implant number
of cc's and cup size in any particular patient.
Keep in mind that following the advice from a surgeon on this or any other website
who proposes to tell you exactly what to do without examining you, physically
feeling the tissue, assessing your desired outcome, taking a full medical
history, and discussing the pros and cons of each operative procedure would not
be in your best interest. I would suggest that your plastic surgeon be
certified by the American Board of Plastic Surgery and ideally a member of the
American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are
comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS
La Jolla, California

Thank you for the question and photos.  You are starting at a nice starting point and should have a nice result after breast augmentation surgery.  Keep in mind, that 425cc breast implants on another person may look very different than what they will look like on you.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. For example, I have found that the use of words such as “natural” or "DD cup” or "overly big" 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.

Thank you for your question and photographs.  In my experience you should establish clear communication with your ABPS board-certified plastic surgeon regarding your size and shape goals.  Show him/her photographs and make sure that you are on "the same page."  Once you are confident that your doctor understands your goals and will do the best job for you, allow him/her to select the final implant based upon the actual appearance of your breast including size, shape and contour during the surgical procedure.  I happen to think that a 425 mL implant is probably in a reasonably good size range for you but the final determination should be made based on your actual results as seen during the procedure rather than how a sizer fits in your bra and looks under clothing.Other doctors take different approaches but this is what I found works well in my practice for over 30 years.Good luck and best wishes.Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)Beverly Hills, California