Would a 275cc or 300cc silicone implant under muscle be best, for achieving my desired result? (photos)

Question

I'm a mom of four kids. My breast have been deflated ever since I stopped nursing. My goal is to gain a full look again (about a C cup) but maintain a natural look. I am 5'5" 145 lbs but lean/ muscular look. I am stuck on chosing between a 275cc and 300cc silicone smooth round moderate profile under the muscle. Which would work best for my desired result?? Although the 275cc seems like a good fit, it may appear smaller once placed under the muscle. Will 300cc be too big? Help. Surgery aug. 30th!

Larry S. Nichter, MD, MS, FACS · Answer

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

Jerome Edelstein, MD · Answer

Hello,Thank you for the question and photos. These implants are very similar and the size difference slight. In my experience most patients do not regret choosing a slightly larger implant when having debated between two. They do often appear smaller once inside your tissues.All the best

Dallas Buchanan, MD · Answer

Thank you for your pictures and questions. Let me first say that all you need to do is take a deep breath and relax. If you have narrowed it down to those two choices, then you are going to do fine and be happy with either. You look like a good candidate for surgery and you should have a nice result. When you really think about it, the 25 cc of volume you are debating is 0.85 ounces, less than 10% of the volume of the implant.....such a small amount. In the end, it will not change the result that much. That being said, I would tell you that if both of the implants fit your chest measurements and are options for you, go with the larger implant. Patients almost never come back complaining they went "too big."Best of luck!

George Marosan, MD · Answer

Thank you for the question and photos. Based on your photos only, I believe either implant size will give you a good result. If both implants fit your measurement, then I would choose the larger one. The volume difference is less than one ounce. Wouldn't lose sleep over it. Good luck with your surgery.

Austin Hayes, MD · Answer

Thank you for your question. It's difficult to give sizing advice online, without an in person examination, measurements, and most importantly getting a sense of your overall size goals.It's important to remember that 15cc = 1 tablespoon, so the actual volume difference between the 275cc and a 300cc is pretty small. Based on your photos you have a good starting place for augmentation surgery, and guessing that you will be happy with either size. Your correct that the muscle pushes the implant down slightly and makes it appear slightly smaller.Congratulations on your upcoming surgery.

Steven J. Rottman, MD, FACS · Answer

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.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The size of implant 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

#RealSelfCORESurgeon

Hector Milla, MD · Answer

Hi and thanks for your question and posted photos, It is very useful to try external sizers in your in office examination, with them you will see something close to wht you will look like after surgery. 275 -300cc implants probably will not give you the wished result. Your surgeon must follow your breast measures.Best wishes.

Derby Sang Caputo, MD · Answer

Hello,  thank you for your question and photos.   After seen your photos I will tell you that neither 275 cc or 300 cc will get you to a C cup.  Your actual breast volume is not that much and your will have them placed under the muscle.   You I will suggest you to have a bigger implant near the 350 cc range in order to have a similar outcome of your wish pictures that you're sending.  Best of luck.

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.   Remember that the 25 cc difference of breast implants you are considering may or may not even be clinically noticeable.  Remember also that the most common regret after this operation is "I wish I was bigger".

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 and that your surgery is coming up soon, 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 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 "full look" or "C 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 for an outcome that you will be very pleased with.

Would a 275cc or 300cc silicone implant under muscle be best, for achieving my desired result? (photos)

Answers (13)

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