I am wanting to know if this is a realistic goal for me? 265cc or 285cc be better? (photo)

Question

Is 265 optimal for me (left) to have this look (right) or would 285 be better? Also, if you notice I have a slight malformation on the right breast as you will see from the symmetry lines I tried to draw. My right breast slants more quickly away due to my chest shape. I wonder, bc this woman looks so similar, is this something that cutting the pectoralis can help to "reshape" for a more symmetrical look? Can you create the pocket where I have marked with the marker?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  You appear to have very realistic goals based on these photographs and you are a great candidate
for a breast augmentation.  265 and 285cc are very close in size.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  This entire surgery
can be performed with a small incision technique.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.  
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Daniel Barrett, MD · Answer

Hi wd11,
  
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, MHA, MS
  
Certified, American Board of Plastic Surgery 
  
Member, Am. Society of Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for your question and photographs. Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend seeing an ASPS board certified plastic surgeon, they are in the best position to ensure that the implants the two of your decide upon are the right ones to meet your expectations. It sounds as if it may be wise for you to "try on" several of the implants so that you can have a better visual representation as to what they would look like. As for your pocket dimensions this can likely be improved at the time of surgery with the dissection of the pectoralis muscle. Best wishes!

Sacha Obaid, MD · Answer

In order to make sure that you have the right breast implant size, it is critical that you do two things.  1.  You need to try them on in a bra and make sure that they look and feel right to you.  2.  You really need 3-dimensional imaging pre-operatively so you can see exactly what you will look like post-op.  Good luck!

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.
  
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
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Ricardo Ventura, MD · Answer

hello , thanks for your question and provided information as well...you are a candidate for a breast augmentation.what you have to keep in mind is that the cc or size is selected with the plastic surgeon in your query, because for photos it distorts what is the actual appearance.

Shelby K. Brantley, Jr. MD · Answer

Hey wd11! Hope you are doing well.  Thank you for your questions and photograph.  You have very realistic goals and I love the fact that you have noticed and pointed out your slight asymmetry.  Some patients are not aware until we point them out to them.  So, with that, you are already ahead of the game.  Between 265 and 285 is only a 20cc difference, which is not worth even comparing size of outcome.  That is such a minimal amount that you probably would not even notice the difference.  I like to tell my patients that if you are considering between two cup sizes, that one must go up about 100cc's to each cup size.  As far as your asymmetry, from your photographs, its not enough to chase after.   I would not go after cutting into the pec muscle because that could lead to other issues and concerns and additionally more asymmetry down the road.  Make sure that your chosen PS takes great photos and measurements and goes over the best cc size and profile that will suit your aesthetics and your outcome should be dynamite.  Good luck and let me know if you have further questions.

Robert H. Hunsaker, MD · Answer

You are over-thinking this. You have good symmetry and position. All the implants do is make your current breasts larger so that starting symmetry of size/position is important. You probably could not even see the difference between those two implants in your body. Just be sure you are confident your surgeon understands your goals (I use photos for that) and let her/him choose the appropriate dimensions of implant.

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.  I also think that your goals are realistically achievable.  What I cannot tell you is exactly what breast implant size/profile will accomplish your goals; in my practice, this is a decision that is usually made during surgery, after the use of temporary intraoperative sizes.  
 Generally speaking, there are several steps taken to select a specific size/profile breast implant for a specific patient. These steps will vary from one practice to another.  I prefer to have a wide selection of implants (all profiles) available in the operating room. I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. 
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. is
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.
In your case, my best advice: more communication. It will definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.
I hope this helps. Best wishes for an outcome that you will be very pleased with.

L. Dwight Baker, MD (retired) · Answer

Certainly you seem to have very realistic goals for your implant size.  There is very little difference between the 265cc and the 285cc implant.  The only way to determine what is best for you requires a consultation with a board-certified plastic surgeon experienced in breast implant procedures.  After the examination to include appropriate measurements, together you and your plastic surgeon can discuss what implant shape, size and profile will be best in order to achieve your final desired result.  The use of the external sizer system in our practice has been extremely helpful in this regard. Keep in mind that breasts are never perfectly symmetric so that they can never be made perfectly symmetric with any technique.  Best of luck to you.

I am wanting to know if this is a realistic goal for me? 265cc or 285cc be better? (photo)

Answers (10)

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