5'4" 125 lbs with 350cc saline HP wanting 500/550cc silicone HP or UHP? Is my BWD of 11cm able to suit this size? (Photos)

Pre-BA I was 32A. I went into my PS's office asking for 450cc's, but he would only go with 320cc HP overfilled to 350. Now, two years later, I'm having a 2nd BA & my PS is suggesting 455cc silicone UHP. I have broad shoulders and have an athletic body and feel as though a larger size would suit my frame better. Is my BWD able to hold 500-550cc? Would it be best to opt for HP or UHP this time? Is it possible to go for an implant with a diameter of at least 12cm on me? Are the pics approx 500cc?

Doctor Answers 7

Do you want to become a revision, revision, revision patient?

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Thank you for reaching out to RS. If this was 20 years ago I could understand you asking for an oversized implant and your surgeon saying "sure". However, it is not 1990, and breast augmentation surgery has evolved. There are several very important reasons why a well-trained plastic surgeon will use bio-dimensional principles to size a breast implant. The most important reason is to prevent damage to the breast tissue, skin, and muscle, and provide patients with a long-lasting breast augmentation.

You are well on your way to becoming a breast implant cripple if you cannot reconcile the gap between your tissues- a narrow (11cm) base width, with your desires to be a certain cup size. While you can certainly ask for an oversized implant, and will probably find a surgeon to perform the procedure, there will be a price to pay, and not just financially. Oversized breast implants may require releasing the pectoralis muscle, or creating a pocket out into the axilla. Implants are far more likely to be visible and palpable through thin skin. With time, the weight of the heavy implant will create stretch deformities and bottoming out. Does this still sound appealing? I suggest that you select a breast augmentation surgeon who can teach you about your anatomy, and breast health. Then you can select the largest size implant that fits your body,makes you happy, and still produces beautiful long-lasting results. 

Sea Girt Plastic Surgeon
4.6 out of 5 stars 10 reviews

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

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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



Implant selection

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Hello and thank you for your question.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 173 reviews

5'4" 125 lbs with 350cc saline HP wanting 500/550cc silicone HP or UHP? Is my BWD of 11cm able to suit this size?

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Thank you for the question. I have found that when a woman wants to increase her size, you need to increase your volume at least 100cc's to notice a difference. Regarding your measurements, you have a petite frame,so the implant that you are requesting is wider than your breast. A large, heavy implant can cause problems such as bottoming out or a permanent change in nipple sensation. It's not that you can't accommodate the implant, but you should discuss all the risks with your surgeon before the exchange. Good luck!

Best Breast Implants for ME?

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Thank you for the question.  There are no hard and fast rules when it comes to diameter of breast implant versus diameter of breast (band width). In other words, these measurements are useful but are only one of the many factors come into play when it comes to selection of appropriate breast implant size/profile.

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, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.

Given your concerns, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.

Generally speaking, the best online advice I can give to ladies who are considering revisionary 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 know 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 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/video, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with. 

Comparing apples to oranges

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So it's really hard to tell what size implants the models you posted have. This is because we don't have any idea what their breast base diameter is. If your base diameter is 11, then the volume of an ultra high profile implant which fits that base diameter alone is around 430cc. There are a lot more factors other than just base width which go into choosing an implant. I think showing your PS photos of breasts you like will help them get you to a place where you'll be happy with your size. You certainly can have an implant with a base width of 12cm. However, if you have an implant which is too wide, it will make your breasts look overly stuffed and will also increase the amount of breast tissue present near your armpit. Best of luck!

~Dr. Sieber

David A. Sieber, MD
San Francisco General Surgeon
5.0 out of 5 stars 40 reviews

Implant selection

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It is very difficult to select an implant of you without a formal exam in person.  Best of luck with your decision to move forward.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.