Choosing between implant sizes and profiles - 220LP or 255MP? (Photo)

Question

I have reached the pre-op point I think many patients will say is the most difficult: choosing between two implants. I am petite: 5’2, 105 lbs, 24” waist with slightly wide set breasts and a 32B cup size. I am choosing now between a 220cc low profile or 255cc moderate profile. I want a natural look, perky and feminine (I don’t want my breasts to be the first thing people notice about me). What would the primary outcome differences be between these two implant sizes and profiles on my frame?

Donald Groves, MD · Answer

Hello and thank you for your question. Honestly, a formal in-person evaluation would be needed to determine the best treatment. There are several reasons for this: 
1) Bra sizes vary based on the clothing store (for example, Victoria's Secret tends to upsize everyone by a whole cup size)
2) Most women do not wear the proper exact fitting bra size for their bodies
3) The exact volume (in cc) needed to change cup size is different for different body types (e.g. 32A to 32D requires a different implant size than 38A to 38D)
4) Be careful NOT to fall into the trap most women do- they see a certain implant size (e.g. 285 cc) or perhaps their friend had a certain size, and they want or request this or another size based on that. Everyone's body is different- 285 cc implants on your friend might look VERY different than they would on you. Be very careful not to make this mistake, because the goal is to find the right size and shape for YOU- for your particular body and your breasts.

Because of those multiple factors, and because it is KEY to fully evaluate your breasts in person to make a full set of precise measurements to select the proper implant for you (incorporating factors like amount of breast tissue, implant type, base width, projection, etc), answering your question really would need a formal personalized consultation- to say anything before that would simply be guessing, which would be both unfair and unhelpful to you.

Your breasts are such a KEY area of your body and your femininity- therefore, you should ONLY trust an experienced aesthetic plastic surgeon. As such an expert, I have had extensive training and experience with complex aesthetic surgeries under a multiple world-renowned experts in the field. I’d recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with aesthetic plastic surgery procedures) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Joshua T Halka, MD · Answer

3D imaging can be helpful when choosing implants, but what it doesn’t show you is how your clothes will fit and how you will look as you go about your day to day life.I would highly recommend you go to ricetest.com and create some rice sizers and then spend a bunch of time trying on different sizers with all your favorite outfits. You will likely end up between a couple different volumes, and whatever one you think might be “slightly too big”, pick that size. The main reason people aren’t completely happy after breast augmentation is that they didn’t go big enough.So once you’ve come up with a size, your surgeon can measure your chest to fine one implant that fits your chest that is close or the same as that size.It is easy to get into the weeds with implant profiles, but really what matters is the volume that will help you achieve the look that you want and then finding what implant at that volume will fit your chest appropriately.
Hope this helps!

Gary M. Horndeski, MD · Answer

At size 32, each 100 cc of implant corresponds to 1 cup size change. Your breasts are widely separated. I recommend a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gianfranco Frojo, MD · Answer

A full shot glass is 44cc. I don't think that there is a noticeable difference between the two. In general, I would recommend to go with either one and there should not be a noticeable difference in the two outcomes.

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

Warren Schutte, MD · Answer

Congratulations on your decision to have a breast augmentation. Making the final size decision may seem very challenging, but it is great that you are the primary decision maker. The biggest different between the two implants you've listed is the profile, not so much the volume difference between 220 and 255. I am assuming you are looking at Natrelle implants. The moderate will give you a little more projection and upper pole fullness. Usually the biggest complaint with implants (especially small implants) is that patients wish they had 'just a little bit more.' I would recommend the moderate profile as it is still a modest implant, just not as flat as the low and low plus.

Frank Agullo, MD · Answer

Thank you for sharing your concerns regarding the choice between two implant sizes and profiles for your upcoming breast augmentation procedure. It's completely understandable that this decision can be challenging, as you want to achieve a natural, perky, and feminine look that complements your petite frame. I appreciate the photos you provided, and I'll do my best to help you understand the primary outcome differences between the two options.

Based on your description and the photos, it's evident that there is very little noticeable difference between the 220cc low profile and 255cc moderate profile implants. However, let's break down the potential distinctions:

Moderate Profile (255cc):
Slighter narrower appearance: The moderate profile implant may provide a slightly narrower breast shape, which can contribute to a more defined and perky look.More anterior projection: This option may offer a bit more projection forward, which can enhance the overall perkiness and femininity of your breasts.

Low Profile (220cc):
Wider appearance with upper pole fullness: The low profile implant may create a slightly wider breast shape with more fullness in the upper pole of the breast.Less projection: Compared to the moderate profile, the low profile implant may have slightly less projection, resulting in a more subtle forward projection.

In summary, you are correct in noting that the differences between these two implant options are relatively minimal. The choice between them may come down to subtle nuances in breast shape and projection, but overall, the visual distinction may not be significant. Both options can help you achieve a natural and feminine look without drawing undue attention.

It's essential to continue discussing your preferences and concerns with your plastic surgeon. They have the expertise and experience to make recommendations tailored to your specific anatomy and goals. Additionally, they can use 3D imaging or other visualization tools to give you a better idea of how each implant size and profile would look on your frame.

Remember that your satisfaction and comfort with the final outcome are of utmost importance. Trusting your surgeon's guidance and having open communication throughout the decision-making process will help ensure that you achieve the results you desire.

Best wishes for a successful breast augmentation procedure and a beautiful outcome.

#Staybeautiful @RealDrWorldWide

Shlomo Widder, MD · Answer

Dear  Virginian,
    Thanks for posting your pictures.  From observing your pictures you appear to be small A cup size with mild ptosis (droopiness). You state that you want to a natural look with perky breasts which are not too big. To achieve your goals I would recommend the following:
1. C cup size is indeed natural looking. To get to that size I would recommend 275 cc or 300 cc smooth, round, moderate profile saline implants (for many reasons, which if you wish I can write them to you or you can call the office and talk to me).
2. To be perky, I would recommend mini lift (donut) procedure.
3. To help achieve the natural look, implants displacement massage is very helpful.
    Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the photo gallery of breasts augmentation with mini lift to make sure that they are numerous, consistent and attractive with nice cleavage, perky and natural looking with nice peri areola scar.
                 Best of luck,
                                 Dr Widder
                       widderplasticsurgery.com

Zoran Potparic, MD · Answer

Regarding the volume there is really not much  difference between 220 and 255 ml. Shape of smaller breasts is definitely better with more projected implants. Decision is always yours. Good luck.

Daniel Barrett, MD · Answer

Dear aeu1923,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery