Speak with the surgeon
Yes, you will need to speak with your surgeon regarding implant selection. Certainly a high/full profile implant will create a fuller breast for the same volume implant. Ask about your options.
Hi SV,Here are a few tips for you because this is perhaps the hardest decision for a patient to make, as well as the surgeon. Also see the video attached to my answer. We spend up to two hours for our BA consults to be sure there is careful communication. We do a full exam in front of a full-length mirror taking six exact measurements. We put your photos on a large computer screen for imaging, and go over your “ideal-size” photos. We then save this information to your password protected “web account.”
First and foremost the implant should fit the dimensions of your breast and tissue cover. Balancing the implant to your over-all body shape and tissue cover is essential. The main thing is to have the diameter of the implant fit the diameter of your breast "foot-print". Higher profile implants tend to have a smaller diameter. Higher is really a marketing term, but often translates into the same volume implant with a narrower base. Saline implants actually tend to decrease in diameter as they are inflated! The average size chosen over our last 7,000 breast implants was “350cc”. BUT, 90% of our patients tell us they wish they were bigger a year after BA. (We will see you every year for routine checks at no charge.) It’s like your mind incorporates the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients that they will experience an increase of approximately one cup size per 200 cc. You can try on implants in the office by placing them into a special bra. The implant is also flattened somewhat when under the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for flattening of the implant in the partial sub-muscular pocket. Once you decide on a size you like, then add on 25cc, because in real life the implant will be flattened slightly by your tissues. Multiple measurements need to be taken to fit an implant to your exact anatomy. Have your surgeon's office show you the charts of the implant dimensions for the various profiles of silicone and saline from the manufacturer. Then you and your surgeon can piece together the puzzle by matching your measurements, with your wishes, versus your tissue cover and the available implants to arrive at a surgical plan. Keep in mind larger implants tend to have more problems over the years. Since silicone implants wrinkle less than saline implants, they might be your best bet.
You can also approximate this at home by measuring out an equivalent amount of rice placed into a cutoff foot of old panty-hose, and put this in your bra. Wear this around the house for a while, and see what you think. Implant size must square with assessments of tissue cover, breast diameter, and chest wall width. Multiple measurements of your chest wall are taken (seven in total). Implant size selection has been an issue of much discussion.
Therefore, I use a wide variety of methods, but the implant size is always established preoperatively. Also, patients are advised to bring reference photos demonstrating their ideal size and shape. A photo album of patient pictures is maintained to assist them. These photos ultimately help in determining where the implants will be placed, since they can be shifted inside (to provide more cleavage), to the outside, up or superiorly, and down or inferiorly during surgery. In determining the final size selection, I always place the highest priority on the preoperative measurements and potential tissue cover. Finally, your verbal requests are factored into the analysis.
We use the quick-recovery approach, so click on the web reference link below to have this explained and you can see the list of Quick-Recovery (Flash-Recovery or Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery journals. It is a surgical procedure that uses special instruments and techniques to minimize tissue damage and avoid touching the ribs. It causes far less trauma to surrounding tissue than traditional approaches, and it dramatically reduces pain and recovery time. In published studies of BA patients, 95-percent of women interviewed after the procedure returned to normal daily activities within 24-hours. Quick-recovery BA is not a “gimmick.” These specialized techniques, which actually speed recovery and get you back to your daily routine, kids and work, are published in our plastic surgery journals. Because these PS journals are “peer-reviewed” and edited, they are the gold-standard in our field as being valid science. Therefore, these are sound techniques, not marketing hype.
Be sure to see only a board certified plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member of ASPS (The American Society of Plastic Surgeons). Also, ask if the PS has an established, high volume breast augmentation practice, performing several hundred breast augmentations each year. Be sure the PS has been in practice for a while, about 20-years might be a good gauge. Does the PS offer all three incisions? Discuss the implant type (gel or saline), shaped "gummy bear" or non-shaped, smooth or textured, implant pocket (over or under the muscle) and the "quick-recovery approach." Ask to see their before and after photos if you didn’t see any on their website. If they are experienced, they should have several 100 breast implant patients for you to view. I would also recommend that your doctor offer you the chance to talk to past patients who would be happy to discuss their experience with you. You need to feel comfortable, so make sure the environment is safe as in an accredited surgery center. Also, ask a prospective surgeon if he or she has ever published journal articles in professional peer-reviewed journals, which they can provide you.
All the best, “Dr. Joe”
I would have to see you in person to determine what implants would be appropriate for you. Once you come to an agreement about the size. then a baggy test may be a good rough estimate to see if the size you choose is satisfactory.
I would suggest 3D photographic imaging to see exactly what you will look like with this implant. Based on the images you can decide it you need to got up on down in size.
Am i not going big enough
If you are not confident with the implant size you have chosen you need to see your surgeon and rediscuss. Bra cup sizes can vary with manufacturer so find the look you like not the cup size. In my office we have sizers and have the patients try on a variety of sizes until they find the look they like and then we determine the appropriate size of the implant. Ask your questions now so you are confident with your choice on the day of surgery. Good Luck
Choosing a breast implant size
This question cannot be answered online. I encourage you to discuss your concerns in detail with your PS before your surgery date in case they don't have larger implants in stock (or maybe they had them reserved for another patient).
Am I not going big enough?
Thank you for your question. An in person assessment or photo is indicated to provide the most accurate assessment. Your surgeon should take into account that the implant will appear smaller once inserted.
Am I not going big enough?
Thank you for your question. Breast implant selection is an important process and requires good communication between you and your surgeon. Typically, breast measurements are initially obtained to provide an initial guide to implants appropriate for your chest. It's then advised that you try different sizers in a normal bra with a tight t-shirt to get an idea of what your breasts would look like. It's important to focus on the look that you want instead of a specific cup size or implant size. Be sure to consult with an experienced board certified plastic surgeon. Good luck!