I'm wondering if I should go with 350cc or 380cc implants as my dr only works in increments of 30cc s ? (photos)

Computer imaging is only partially accurate so do not put that much weight into these photos. Secondly 30 cc's is only a shot glass as a good visual volume equivalent.  Silicone implants are factory sealed and about 30 cc's between most sizes, whereas saline implants are filled at the time of surgery and any amounts within size range of implants possible. It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon.For slender women such as your self without much breast tissue, I recommend a silicone and not a saline implant as it will be softer and feel more natural. Additional critical decisions will also be made by your plastic surgeon such as: whether your implants will be above or below your pectoralis muscle. These choices are recommended to you based on the look you desire, the amount of sagging you may have, and other deciding factors. For more than 25 years, I have tried just about every method to best understand and achieve the patient’s optimal goal. The following is what I have found to be most accurate: To start with, I have found it most helpful for patients to bring in photos from my or other plastic surgeons’ websites to illustrate what they would like to look like. This gives me detailed standardized views and information both qualitative (shape, perkiness) and qualitative (size) and allows me to discuss with my patients how I can best achieve their objectives as well as realistic expectations. For example, though I always tell my patients that I cannot make them exactly the same as a photo because everyone has different anatomical constraints. However, these ”ideal” breast photos are brought to the operating room for reference during surgery so that I have the advantage of “seeing through my patient’s eyes” to best achieve their wishes. Even if the photo does not match their height or weight, I and most plastic surgeons are very good at translating the proportionality of the photo to your features.I personally order more than one set of implant sizes and use sterile implant “sizers” (temporary implants) placed in the created implant pocket during surgery to know in advance exactly which implant would work best for you in both a sitting and lying down position. This also allows me the opportunity to modify the pocket to meet some of the more subtle shape features desired. This enables me to use my full artistic potential to achieve your desired goals.                    

If you examine your before & after photographs,
you will see that you have widely separated breasts with minimal cleavage and
your nipples are pointing outwards.This
will only get worse as the implants descend from gravity and muscle
contracture.Implants alone will not
solve your problem and you need a lift.Most women refuse lifts because of the ugly vertical scars of the
traditional technique.I recommend a new
technique called Breast Augmentation with Mini Ultimate Breast Lift™.Using only a circumareola incision it is
possible to reshape your breast tissue creating upper pole fullness, elevate
them higher on the chest wall and more medial to increase your cleavage.Aligning the areola, breast tissue and
implant over the bony prominence of the chest wall maximizes anterior projection
with a minimal size implant.Small round
textured silicone gel implants placed retro-pectoral look and feel more
natural, are more stable, less likely to ripple or have complications needing
revision.Implant profile is irrelevant
in the retro-pectoral position since the muscle compresses it.Unfortunately, you have not told us your bra
size but if you are 32 or 34 each 100 cc’s of implant corresponds to 1 cup size
change.If you are 36 or 38 each 200
cc’s of implant corresponds to 1 cup size change.From this, you can compute the volume
required to achieve your desired goal.Best Wishes,Gary Horndeski, M.D.

Compter imaging is a good communication tool but not totally accurate in predicting outcomes. The best cosmetic result in
any particular breast augmentation patient depends on a variety of factors,
including: your individual anatomy, realistic expectations, a thorough
discussion with the plastic surgeon about the options, and an understanding of
the pros and cons of any particular implant choice. Proper sizing is not just
about the number of cc’s. The thickness of your tissue, breast dimensions which
include the width, height, and projection, as well as chest wall width all need
to be considered when choosing an implant. Trying on implant “sizers” of
various shapes and volumes while wearing a tight t-shirt, bra, or bathing suit
at a preoperative visit will help you and your surgeon choose the optimal
implant.

Keep in mind that following the
advice from a surgeon on this or any other website who proposes to tell you
what to do without examining you, physically feeling the tissue, assessing your
desired outcome, taking a full medical history, and discussing the pros and cons
of each operative procedure would not be in your best interest. I would suggest
that your plastic surgeon be certified by the American Board of Plastic Surgery
and ideally a member of the American Society for Aesthetic Plastic Surgery
(ASAPS) that you trust and are comfortable with. You should discuss your
concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California