240cc vs 265cc and moderate vs. high profile?

Question

Going in for my BA Wed! I still hvn't committed to an implant. Mostly out of confusion. I've had 6 diff. consults and each of them had diff. measurements and opinions. Biggest fear is looking like I gained weight. I'm petite and exercise a ton. I want to look natural. I am 115, 5'3" and a 32AA. The PS I chose recommends a 265cc HP and measured my BWD 10.5 I'm afraid of being too big so they have the 240HP & mod on hand. (I had one PS measure me a 9 W/ UHP and another had 12.5 w/ 250 Mod+. Help!

Vaishali B. Doolabh, MD, FACS · Answer

Hi brookelbm.  There are several considerations:  implants placed under the pectoralis muscle will look natural and help avoid looking over done, so be sure to ask about placement.  Secondly, the narrower implants with higher projections will maximize cleavage (broader implants at the same volume will be wider and create the look of gaining weight) and are well suited for petite frames (broad implants will create a lot of side fullness).  The difference in volume between 240 and 265 are only about 2 tblsp so not much difference.  Consider trying on sizers that mimic your two choices, and talk to your PS again-they have experience with all different implants and outcomes with patients with different frames. Good luck!

Andrew T. Lyos, MD, FACS · Answer

Thank-you for your question. Selecting the correct implant size is among the most important decisions in a successful breast augmentation procedure. Placement of the identical implant will not produce the same results in all patients due to differences in:
1.Dimentions of the breast 2.Diameter of the chest 3.Volume of breast tissue 4. Height and weight 5. Breast shape, including breast ptosis and asymmetry
I rely on 3 methods to advise my patients:
1. Dimensional planning 2. Gel implant sizing 3. 3-Dimensional Vectra imageing system.
 At the time of consultation, measurements are taken allowing for dimensional planning to select the implant which best fits the base diameter of the breast. Gel implant sizing is performed to allow you to visualize augmentation the with the various sized implants. Vectra 3-D imaging has been a very important method in my practice in selecting the correct implant size and shape as it allows you to see what you will look like following augmentation with any of the available implants.
Best wishes
Andrew T. Lyos, MD, FA

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  Congratulations on your upcoming surgery.  The
best advice you can receive is from an in-person consultation.  240-265cc seems reasonable based on your measurements and goals.  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.  
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Jerome Edelstein, MD · Answer

Hello,Thank you for your question. The volumes that you've listed sound more like moderate and full implants. If so, the measurements for 240-265 would be appropriate for your size. None of those is huge- though I probably wouldn't recommend an extra full or ultra high profile unless you want to be as big as possible.  A variety of consultations can be helpful for comparison but also confusing when conflicting information is presented. Dimensional augmentation takes into account your existing tissue and measurements as well as your desired look. My patients also find it helpful to try on the implant sizers with a form-fitting T-shirt in order to get an idea of how they will look.  I recommend that you discuss your concerns further with the board certified Plastic Surgeon with whom you are the most comfortable.All the best

Aldo Guerra, MD · Answer

Hello Brooke.Both sides are very similar. They both will make you look natural. You should discuss this once more with your plastic surgeon, but either way I see lots of improvements in your case. Best wishes, Dr. ALDO :)

Jennifer Boll, MD · Answer

I think that from your measurements you will do great with either implant. I would probably recommend the larger of the two implants but it is difficult to be sure without seeing you and talking with you in person. To help reassure you, the difference between the 2 implants is only 25cc. That is less than an ounce. You should do great with whichever one you chose. Good luck!

Sean Doherty, MD, FACS · Answer

Unfortunately, choosing the right size implant definitely requires an in person exam. Assuming that you trust your surgeon then trust his or her recommendation. Your size range seems appropriate given your measurements. Best of luck.

Lawrence Scott Ennis, MD, FACS · Answer

The best way to pick implant size is based on your breast and chest width and not the volume. As the implants get bigger, they get wider. When the width of the implant fits the width of your chest, it will look nice and fit your frame. If the implants are too small, you will have a gap between them and they may look too far apart. If they are too wide, they will make you look top heavy as they may be too wide and stick well out past the sides of your chest. There are ways to get a bigger or smaller look.This can be done by picking a different implant profile. The higher the profile, the narrower the base width of the implant. If someone has a very narrow chest and wants to be big, they should consider a higher profile implant. If someone has a broad chest and they do not want to be too big but want to avoid the gap and still have cleavage without projection, they should consider a lower profile implant such as a moderate. There are options in between these such as the moderate plus. I prefer the underarm approach so there is no scar on your breast. The new silicone is the only way to go as far a rippling as the new silicone ripples much less than saline, especially in the larger implants. Dr. Scott Ennis

Brian Coan, MD, FACS · Answer

Thanks for your question.  Since there is no way to say definitively over the internet which size would be optimal for you, take comfort in the fact that the surgeon uses your unique measurements and is able to provide you with a general range.  In many cases the board certified plastic surgeon can best be your guide as they’ve met with you in person and heard your aesthetic goals. You may consider doing 3-D imaging; however with nearly all the breast cases we’ve performed, we’ve found patients enjoy doing a live “try on” session where they actually can “try on” the implant in a non-padded bra in our office.  This does not give an exact measurement of outcome, rather it gives a nice idea of what to expect. For patients who desire a more natural look we like to recommend the shaped implant.  For patients who desire a more full, voluptuous look we recommend a higher profile implant (like Inspira). Remember that all breasts have at least some amount of asymmetry (we like to say they’re like sisters and not twins).  An in-person consult is the best way to discuss your questions.   Be sure to find a surgeon with the following credentials:  *Board Certified by the American Board of Plastic Surgery -- The gold star symbol   *A member of the ASPS (American Society of Plastic Surgeons) -- The circle symbol  *A member of the ASAPS (American Society of Aesthetic Plastic Surgeons) -- the Queen Nefertitti symbol with a Triangle.  Feel free to contact our office, it would be our pleasure to answer your questions in person.  My best, Brian Coan, MD, FACS

Maida Parkins, MD · Answer

The difference between 265 and 240cc is actually very small.  I always have patients me bring photos of their desired look that I take along to the operating room to help make the final decision on size ( I sit the patient up and then compare it to the photos of the look they desire).  I often use high profile for petite patients, patients with a narrow chest width, those with very little of their own breast tissue or those who want more projection.  It sound like you probably fit into that category.  If you are looking for something natural UHP is usually too much.  I recommend you discuss this with your board certified plastic surgeon ahead of time- you don't want to be worried about making an important decision the morning of surgery.  Best wishes!

240cc vs 265cc and moderate vs. high profile?

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