Getting 455cc Uhp Silicone Unders - I Have a Bwd of 11 and Am Starting As 34B - What Size Am I Likely to Be? (photo)

Question

With a bwd of 11, I'm planning on 455cc uhp silicone unders (that are 11.3 wide). Currently, I am a 34B... What size of bra will I most likely be? I know you move through cup sizes faster with smaller bwd, I just don't know how much. I'm 5'5" and 113 lbs :) I'd like to be big without looking unnatural. I was thinking 34D or small 34DD? Thank you so much for your feedback!

Gerald Minniti, MD, FACS · Answer

Hello,

	Your decision to use an UHP implant based on it matching your narrow breast width ignores many other measurements crucial in picking a properly sized implant.  Aside from the fact that HP and UHP implants are most likely to cause post operative problems requiring reoperation, they do not create a 'natural' look, I think in anyone's conception of what 'natural' looks like.

	The truth is, if you are thin and have little breast tissue, it is impossible to augment your breasts so significantly and have them look natural, especially if you use an implant that is shaped like a ball. 

	It is unclear if you have seen a plastic surgeon yet, or you have just been doing your homework on line.  I suggest that you see a surgeon that will talk to you about the limits of what breast augmentation can achieve, the risks involved in using implants that are anatomically too large for your body, and the long term effects of large implants on your rib cage, breast tissue, and skin.  Please choose a surgeon that is a member of the American Society for Aesthetic Plastic Surgery who specializes in all types of cosmetic breast surgery.

	Best of luck!

Richard H. Tholen, MD, FACS · Answer

Sorry, without an examination I can't say for sure, but at 5'4" to 5'7" of height with the photo you provided, I would estimate your breast base width (or more accurately, your anticipated pocket width) to be closer to 14cm. Your surgeon should use the widest implant base possible for the implant volume you choose (of course subject to the absolute anatomic capacity of your tissues).

	Ultra high profile implants, especially 455cc ones, will be very round and baseball-like. This is neither natural-appearing nor does it give you a nice cleavage. I believe that it takes 250cc to equal about one bra cup size, so your volume choice is pretty much "right on," IF your breast dimensions and tissue capacities permit that size with appropriate movement of the implants in their pockets so they stay soft, move normally, and feel natural. (As opposed to looking and feeling like immobile, hard, round "Baywatch coconuts!")

	If that volume fits you, I would try for moderate plus first, then consider high profile if the M+ are too wide. But not UHP! My opinion, but truly, I believe an appropriate one for your description of your goals! Best wishes! Dr. Tholen

Paul Gill, MD · Answer

Thank you for your question. It is much better to accurately discuss implant volume and projection with an in office exam and detailed measurements. In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements/characteristics. I use these measurements to help me during the sizing process to guide you to a safe result for your chest wall and just as important, one that meets your end desires.The next step is to try on this range of implants in the office with your doctor. The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant. It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you during the sizing process. In addition, review of photos and use of rice bags can be very helpful to the patient and surgeon in achieving a safe and happy result. Close intereaction and involvement from your surgeon during this process can help alleviate the anxiety and fears of choosing the right size. I wish you a safe recovery and fantastic result.Dr. Gill

C. Bob Basu, MD, MPH, FACS · Answer

It is very difficult to predict what cup size you will be after your procedure.  Cup sizes are not standardized.  So a D cup in one designer could be a C cup or B cup in another designer.   This is the approach I use to help guide my patients with their implant size selection:

	I consider two factors when selecting implants for my patients:

	1.Dimensional planning
	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. Your surgeon can review this with you during the consultation.

	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.  If you have decided on saline implants, then based on the gel sizer you select, we can guide you to the saline implant that achieves a similar look.
	Hope this helps.
	Dr. Basu
	Houston, TX

Victoria Yongsook Suh, MD · Answer

Not all bras are equal in sizing. Estimates may be made but cannot be guaranteed. I would recommend working with your Plastic Surgeon to determine the implant size that best fits your body. Although not 100% reliable, a reasonable range of implant sizes may be tried to determine the appearance that you like the most. Patient satisfaction is higher when appearance is at the center of the choice rather than the cup size. In many of my patients, HP and UHP implants are my primary choices. With these implants, it takes good 3-6 months for the implants to settle and for the lower pole to expand into a natural shape. However, my patients with HP and UHP are very pleased with the projection and the fact that the implants do not protrude into the axilla. Consult with your Board Certified Plastic Surgeon, 2-3 times if necessary. Best Wishes!

Darryl J. Blinski, MD · Answer

Can only give you a guess via the internet - maybe a D cup. But this should be asked to your chosen surgeon in the pre operative interview.

Brian K. Brzowski, MD, FACS · Answer

Hawny,

	I trust that before settling on the 455cc implants that you were offered a chance to try them on to see how they look on your body.  While this is not an exact representation, it gives you a good idea of what to expect.

	Hopefully, you are working with an experienced, board certified plastic surgeon who can answer these questions for you.  My suggestion would be for you to ask him or her these questions (since they know you the best).  That way you'll get the best answer and best result possible.

	Good luck!!!

Jourdan Gottlieb, MD · Answer

There are no fixed definitions of cup size. I have numerous patients who have bras that fit of 3 different cup sizes. They can say they are B, C or D and have the bra to prove it. 

	Many surgeons estimate a cup size increase for every 150-250 cc of implant. 

	I do occasionally use extra high profile implants for patients who want maximum size and don't care too much about what I would consider a natural appearance. The only patients I have seen who look reasonably natural are patients who are quite heavy. 

	Were you my patient I would probably prefer using a high profile implant, which at your width would be limited to about 325 cc. 

	All the best.

Scott L. Replogle, MD (retired) · Answer

I would generally agree with Dr. Gottlieb's response and disagree with the idea of using external sizers to judge size/result. 

	The average breast width is 13 cm. I would recheck your breast width standing upright with arms down. If it is indeed 11 cm, then the width of the implant that fits properly behind your breast should be about 10.25 cm. If the profile is the normal high profile (Allergan or Mentor in saline-filled or gel-filled), you can expect to look about two cup sizes larger than you are now with the same chest circumference. There is no exact measure of breast size before or after augmentation and cup sizes are far from exact or defined. 

	Generally the breast tissues can tolerate the pillow volume of an implant if it matches the inner width of the breast and it's within the range of low, medium, or high profile. If you try to put an implant in that is larger than the width of the breast or has a profile beyond a high profile you are asking for stretching, distortion, or malposition of the implant much like putting too big a foot into too small a shoe. You might get away with it but your odds of an unnatural look or needing a revision go up significantly.

Getting 455cc Uhp Silicone Unders - I Have a Bwd of 11 and Am Starting As 34B - What Size Am I Likely to Be? (photo)

Answers (9)

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