Downsizing from 500/550cc high profile implants - Which Size/Profile is Ideal for My Body Frame? (Photo)

Question

I have surgery scheduled in couple of weeks for an Implant exchange and lift. I am downsizing from 500/550cc high profile implants to 350cc ultra high. Will this implant size be ideal for my body type. Will the ultra high profile projection still be too much? I am 5’3 and weigh 165lbs.

Daniel Barrett, MD · Answer

Dear sweetpea212,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Donovan Rosas, MD · Answer

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." 
Your implant choice seems reasonable, but more detailed advice cannot be offered without exam/measures.
Communication is key as you and your surgeon create your custom surgical plan. 
As always, discuss your concerns with a board certified plastic surgeon.

Wayne I. Yamahata, MD · Answer

Both downsizing the volume and going to a higher profile will reduce the base width of the implants. The consequences of this should be discussed with your surgeon.  He or she has probably already assessed this by taking measurements and can explain the rational for the recommendations.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Michele A. Shermak, MD · Answer

Hello and thank you for your question. 
Downsizing to an ultra high doesn’t make sense to me. Typically when downsizing we talk about going down in profile, not up in profile. Furthermore, this implants choice significantly narrows the implant over reducing the projection/size. I would imagine you would go from a high profile to a moderate plus profile. Have you looked at the current and planned implants against each other? Considered a gummy bear style silicone in your exchange? Those might be helpful to see.
Best of luck to you. As long as you’re ahead of surgery time, you still have time to consider change in sizing up to the day of surgery.

Robert M. Wald, Jr., MD · Answer

The size of the implant is best determined by the patient. Everyone has their own concerns and ideas about breast volume. Reducing your breast implants by 200cc's, this will make you approximately 40 per cent smaller.  If you are OK with this, the 350cc's will be fine. I would personally choose the high profile over the ultra high profile. I would discuss this with your surgeon.

Gary M. Horndeski, MD · Answer

Your breasts are large and low on the chest wall. I recommend explantation and breast lift using The Bellesoma Method. The implants are removed, your breast tissue creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Downsizing from 500/550cc high profile implants - Which Size/Profile is Ideal for My Body Frame? (Photo)

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