Unfortunately, the definition of a DD cup varies from patient to patient and for this reason, cup size represents a tremendous source of confusion amongst cosmetic breast surgery patients. Furthermore, CC's aren't easily translated into cup size and this also creates confusion.
For this reason, it's virtually impossible to answer this question without a consultation and a physical examination. When choosing breast implants for breast augmentation, we aren't interested in implant size, but instead we're interested in implant fit. We want to achieve harmony, balance, and proportion with the surrounding anatomic structures.
The best approach to resolve this issue is consultation with a board certified plastic surgeon. In an effort to minimize confusion, we utilize external implant sizers. This system helps the surgeon understand the patient's aesthetic goals. They also significantly alleviate the anxiety that many patients experience regarding breast implant size.
In terms of picking the right implants to achieve your goals, generally speaking, I consider two
factors when selecting implants for my patients:
1. Dimensional planning
2. Gel Implant Sizing system
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. Hope this helps.
There is no precise formula for choosing implant
size and geometry, as a lot has to do with the existing breast volume, breast
base dimensions, and location of your breasts on the chest wall, and then your
personal desires. This includes how natural versus how obviously
augmented you wish to appear. You will find that there is a range of
effective volumes for each patient, below which the breast will not be
adequately filled and will not reach its best shape potential (least effective
volume), and beyond which (maximum effective volume) the breasts will give
up natural shape for the sake of additional outcome volume.Additional volume can be added beyond the
maximal effective volume, but will transform the shape to a less
natural-appearing roundness and then on to a completely fake-looking shape,
eventually reaching a point where the addition of further volume requires
destruction of internal muscle and fibrous support structures, and breach of
breast landmarks (mainly the folds), which in some patients will lead to double
fold contour deformity, bottoming-out, symmastia etc. Implants that are too large in the presence of mastopexy can also lead to scar spread or would healing issues due to excessive stress on the healing wounds. Implant
Sizing schemes with, external implants in a bra, may be of some help, but
can be misleading if an implant volume and width is desired that is beyond
the capacity of the breast fold geometry, particularly if there is mild skin
overhang over the lower pole fold (dedicated fold geometry), or in your case, the need for a mastopexy. I find
that bringing photos of similar shaped women's results can help in the
discussion, but realize that photos can only be used as a theme for what
you are looking for, and not like a catalog from which exact sizes
and geometries can be ordered. I hope that this helps a
little, as this is a complex issue. Study this well and ask informed
questions as it will help in the process.
It is very difficult to determine 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 350 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. . 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 below link.
Many plastic surgeon's offices use a 3D imaging device, so that ladies can see what it may look like for breast augmentation prior to surgery. It is no guarantee of result, but it sure if fun to "try" on different sizes. We use Crisalix in our office to help our patients with these choices.
Thank you for the question. Generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting 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. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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. I have found that the use of words such as “natural” or "DD or DDD cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. Therefore, I ask that my patients not base their communication preoperatively OR their satisfaction with the outcome of surgery postoperatively, on achieving a specific cup size. The use of computer imaging may be very helpful during this communication phase.
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. The use of temporary intraoperative sizers, viewing the patient's breasts in the upright and supine position, are very helpful during the breast implant selection process.
I hope this, and the attached link (dedicated to breast augmentation/lifting surgery concerns), helps. Best wishes.
I would try on sizers in the office to help get an appreciation of the volume you want.
Kenneth Hughes, MD
Los Angeles, CA
The first comment I have is that I agree 100% with Dr. Corbin's recommendation: forget the cup size as an absolute measure, and put sizers in your bra until you find the volume of breasts that you like. I can't tell you how many ladies I have in my practice that first think they want to be the proverbial "C" cup, only to pick a size of implant that puts them in a D or DD postop . . . and yet they are thrilled! Thus, preop "guesstimates" of cup size are very inaccurate, and using visual clues like sizing or pictures for proportion/shape, projection (front and side of breast/chest), and and other specific goals related to breast volume or shape is much more reliable. The other point to make is that breast lift procedures allow for adjustment of actual breast tissue volume, just like a breast reduction, and sometimes a surgeon will take off some of the lax natural breast tissue which has lost its volume and tone and replace that with the volume of an implant, which will retain its volume, shape, and tone longer. Thus, the final size of implant may change even at the time of surgery. For this reason I go into operations like this armed with as much information about the specific goals and "visions" that my patients have for themselves, which we can most effectively gather from pictures and detailed discussions, and then have a range of implant volumes available to me, so that during surgery we can make the necessary adjustments and arrive at our final goal accurately. Make sure you have a good discussion with your surgeon about your goals from the standpoint of appearance as opposed to numbers, and that you are confident that he or she understands what you desire and can deliver that. Good luck.
It is impossible to know what you would benefit from without photos. You may or may not need implants depending on how much breast tissue you currently have and what size you ultimately want to be. Often, in a case like yours, I will perform the lift first and then decide after healing what size implants to use. It's also safer to yes the two stage approach.
Thank you for your question.
sizing is only one important aspect of picking the correct implant:
1) size in cc's (1 oz is approx. 30 cc)
2) filler material (silicone gel vs normal saline)
3) shaped vs round implants
4) smooth or textureed
I suggest you make a appointment with a Bd. Cert. Plastic Surgeon and bring photos of what you desire. Most surgeons will let you try on various implant sizes ("test drive").
my best wishes,