335 cc vs 295 cc implants?

Question

I'm 5'4, 135 lbs and 21 years old, no kids. My doctor said I have constricted lower poles so getting a bigger size is going to increase my risks of indentations, etc. I don't want 295cc I feel it's too small and I REALLY want 335cc but I'm scared of all the risks involved. My nurse said I'm at 40% more chance of risks and have to sign a separate waiver form for large implant not recommended if I go with 335 cc. I am afraid of double bubble as well. What should I do? I'm getting under the muscle.

Ricardo A. Meade, MD · Answer

Your plastic surgeon has had years of training in both surgical techniques and aesthetics to learn how to take your anatomy into account and make the best recommendation for your unique breast structure and chest. Your plastic surgeon should also have done many breast augmentations, which gives him or her even more experience in how to create beautiful results. If you have doubts, though, it may be worthwhile to schedule a consultation with a different board-certified plastic surgeon to see what he or she recommends.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The best way to determine implant size is based on chest wall measurements that fit your body.  Once we determine that we can choose the profile based on what you want or need to achieve.

Implants under the muscle, there is less risk of capsular contracture.  Anatomic implants tend to give a more natural shape with more nipple projection.

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

Austin Hayes, MD · Answer

Thank you for the question.Without photos it's very difficult to answer this question. It's important to remember that the 40cc difference between these two implants is relatively small. 15cc = one tablespoon. It sounds like the communication between you and your plastic surgeon could be improved. You should have a close enough relationship with your surgeon, so that these tough questions get answered by having a back-and-forth dialogue. I would consider additional consultations with board-certified plastic surgeons who can give an additional opinion how best to proceed.

Stuart A. Linder, MD, FACS · Answer

I believe the low 300cc implant are reasonable and safe to be placed by a breast implant specialist in your area. Best of luck

Aldo Guerra, MD · Answer

Thanks for sharing your concerns. I think your doctor is trying to do the best for you based on your anatomy with construction of the lower pole. I would suggest you get a second opinion from one or two additional plastic surgeons before moving forward. There are other sizes between 295 and 335 that you should explore before committing to a size. Best, Dr. Aldo

William Andrade, MD · Answer

Thank you for your question.  Unfortunately without a proper assessment there is no way to confirm your surgeon's recommendations.  If you are still uncertain how to proceed, perhaps you could arrange a second opinion with an experienced local plastic surgeon.

Michael F. Bohley, MD · Answer

A constricted lower pole makes breast augmentation more challenging, and as you've stated, runs an increased risk of a 'double bubble' deformity. As with any elective surgery, it is very important that both you and your surgeon are 'on the same page' with the operative approach. Your surgeon has likely done a careful examination and assessment to arrive at the recommended implant volume. However, if you are still uncertain about this or other aspects of the operative plan, then one or more independent consultations may be helpful.

Eric E. Wegener, MD · Answer

Without pictures of your breasts and chest wall, a definitive answer is difficult. In reality, there is minimal difference between the 2 implant sizes. In my practice we concentrate on your wants, desires, and goals and do not tend to get fixated on specific volumes. Frequently to correct the true constricted breasts, moving the nipple to a higher position will solve the issue.  I would seek an alternative opinion.

Tom J. Pousti, MD · Answer

Thank you for the question.  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.

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 "C or D 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 surgery for patients with constricted breasts) helps. Best wishes for an outcome that you will be very pleased with.

Mahmood Kara, MD - Account Suspended · Answer

Hello. Thank you for your inquiry.
You may be an excellent candidate for breast augmentation surgery. Exact end results and cup sizes are usually quite difficult to calculate as everyone has a different starting point.
It is important to have an in-person assessment regarding your concerns as it is difficult to determine virtually.
There are many different factors that go into choosing a breast implant size which will correspond with your body dimensions while concurrently achieving your aesthetic results. Some of these factors are: Implant size (CC's), Implant profile (Low, Moderate, High), Placement of the implant (Subglandular vs. Dual Plane) etc. We utilize smooth round cohesive silicone gel 'gummy bear' implants for the best results.
During a consultation your aesthetic goals are heard and taken into account with the measurements of your breasts and the integrity of your tissue, as well as level of ptosis (sag). From here we collectively can find your 'perfect fit'. You are able to try out sizers and different implants in our office such that you can get an idea of what size you would be post-operation. We also offer Crisalix 3D plastic surgery virtual simulator during our in-person and virtual consultations to preview potential results. After your consultation, you will receive your very own implant sizers to take home with you (at a small cost) whether or not you decide to go forward with your procedure.
I usually recommend that my patients stop smoking, take vitamin C daily, and avoid aspirin/ibuprofen and vitamin E 3 weeks prior to surgery. I specialize in the 24-hour Recovery method which minimizes trauma to the breast and decreases pain post-operatively.
We encourage you to look at our website and Instagram (drkaraplasticsurgery) for lots of before and after pictures!
Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.
During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery.
We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!
M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind

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