Would 485cc silicone implants be too big for my shape? Would 450cc be better? (photo)

Thank you for your picture and questions. I often hear patients that spend a lot of time going back and forth on size. The bottom line is most of the time, it is not worth the struggle. If you are considering 450 vs 485 cc, that is a difference of 35 cc. To put that into perspective that might be easier to visualize, that is just over 2 tablespoons....that's it! You probably would not even be able to tell the difference between the two once they are in place. Usually when choosing between two sizes, as long as the dimensions (width) fit your chest, most patients go with the larger size and are happy with that decision. Last thing, make sure your surgeon is board certified by the American Board of Plastic Surgery!Hope this helps!Dallas R. Buchanan, MD, FACSOwner & Board-Certified Plastic SurgeonVIVIFY plastic surgery

Dear hairxobarbie,
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

Since you had a pregnancy and have gained weight, you would also benefit from a lift, perhaps more than augmentation.  In your photograph, it appears your breasts have descended down your chest wall.  The technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained.  At the same time or later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

35 cc is not going to make a significant difference in your end result. That being said, most plastic surgeons would use a series of sizers during your surgery to determine which implant fits your pocket and your body the best, in conjunction with your pre-operative aesthetic goals. Oftentimes this actually leads to using two different sized implants to achieve the best symmetry. Typically most palstic surgeons do not commit to a specific size pre-operatively as things in surgery can lead to different choices. Both implants will likely lead to an amazing result! Good luck!

The volume difference of 35 cc's is so minor you are stressing over a non issue. If you were choosing volume over 100 cc differences than I would recommend in person second opinions. But for 35 cc's swing, just go with the very slightly larger volume. 

My best advice: more communication.
It is 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.
One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?
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 revisionary 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.
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.
I hope this helps. Best wishes for an outcome that you will be very pleased with.