I'm 40 years old, 155 lbs, 5'8" tall, currently an A cup, and I want to go to a full C or small D with silicone implants. Which size and implant placement (over or under the muscle) would be ideal for me and why?
Which Breast Implant Size and Placement is Ideal for Me?
Doctor Answers 20
The size and implant type are determined by soft tissue characteristics and body habitus
The size and implant type are determined by soft tissue characteristics and body habitus.
It is important to understand there are two types of breast surgeons - size surgeons and shape surgeons. It is my opinion that those who favor an ideal shape are better surgeons who serve patients' best interest, as they value long-term results over short, fleeting results.
Remember that saline and silicone implants often look exactly alike when a fair amount of breast tissue is present to cover the implant.
The feel however is usually softer with a silicone implant in general.
Sizing and Implant Placement
A generalization about cup sizing is 225-250cc will increase one cup size. However, there is no direct correlation or measurement to guarantee a cup size.
Try putting dry rice in a zip-lock bag and place this in yoour bra. Add volume until you get the look you like. Bring this to your plastic surgeon who can measure the amount and use this as a guide in determining a desireable size for you.
I offer 3-dimensional imaging which can produce a simulation of yoou with different size implants to help you find the size that matches your goals.
The question of under- or over-the-muscle is best discussed with your surgeon to determine what might be best for you.
There is no single correct answer
This is a very good question without a simple answer. First, the choice of size is entirely subjective, so everyone has their own idea about what is right. There isn't any formula based on height and weight. It is not uncommon for us to see a patient a week after surgery who feels that they made the wrong choice because the implants look too big; then after the swelling subsides and the implants settle a bit, they look just right. But a year later they might feel that they should have gone a little bigger.
Secondly, cup size is just not an accurate way to describe breasts. It varies according to manufacturer, and relates as much to the dimensions of the chest as to the actual volume of the breasts. My recommendation is for you to be involved in the decision up front and not leave it up to the surgeon alone (some surgeons feel differently). The best way is to try samples of various sizes tucked into a bra with a cup size you like.
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Measure, then pick the size; don't focus on cup size.
While there are charts as to implant size and expected cup size that you are no doubtr familiar with, this does not tell the whole story.
We try to place implants below the muscle, because the blood supply between the muscle and the skin above is preserved. Also, there is a much lower chance of scar formation requiring reoperation when the implants are placed below the muscle.
We measure the diameter of the breast first, and then discuss which implants will fit into that diameter, rather than focus on a particular desired cup size. The maximal measured diameter defines the maximal implant size. For patients needing the biggest possible implant, a high projection implant may be best.
However, the implant must still fit into the patient. Larger implants can necessitate big pockets, sometimes meeting in the middle (synmastia), causing permanent disruption to the muscle that attaches to the sternum, or projection into the armpit.
Also, the muscle in a patient who has very small breasts may be very tight, in some patients it may be very difficult to fit in such a large size difference as you are seeking (A to C or D).
Bra sizes are notoriously unreliable. Women with a B breast come into my office convinced they are an A, a B or a C, just because that is the size they are most comfortable with.
I know many fine doctors differ with me on this point, and place very large implants. However, I believe that large breast implants cause large problems, including thinning of the tissues, disruption in blood supply, fast drooping, visibility of the implant, rippling, greatly increased need for revision surgeries, etc. I understand that at the Playboy Mansion I am considered a conservative doctor, guilty as charged. But I suspect in 10 years time, my patients will fare much better with appropriate moderate sized implants than patients who have received huge implants.
Try The Rice Test
The best way to determine what implant size will give you your desired result is to see a plastic surgeon and be evaluated in person. However, there is a way to try to figure out what implant size you like at home.
The rice test: Fill knee high hose or cut off panty hose with dry rice to make an "implant" to stuff in a sports bra. Adjust the amount of rice until you get the desired effect. Once you know what looks good to you, measure the amount of rice. One cup rice is approximately a 236 cc implant. You may calculate partial amounts from there, e.g one half cup is approximately 118cc's. If the implants will be under the muscle (most are) add about 15% more to the final calculated amount of cc's.
This test is not exact but may give you an idea of how much volume it will take to give you the fullness you desire. It may also be helpful to your plastic surgeon to know the results of the rice test.
Breast Implant decision making
It is very difficult to determine the exact size and shape of implant that will fit your frame without an examination by a board certified plastic surgeon. 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 tough to answer your question. For example your native 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, but much less of a difference if you have a wide chest wall and wide breast “foot print”. 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. I always find it helpful for patients to bring in photos from my or other plastic surgeons’ websites to illustrate what they would like to look like. I bring these photos to the operating room for reference during surgery so that I have the advantage of “seeing through my patient’s eyes” to achieve their wishes.
I personally order more than one set of implant sizes and use sterile sizers placed in the pocket during surgery to know in advance exactly which implant would work best for you. Software morphing programs 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).
My advice is to accept advice from your board certified plastic surgeon after a formal consultation and examination with measurements.. If still confused don't hesitate to get a second opinion.
There is no way to guarantee a particular bra size. Bra sizing varies greatly between bra manufacturers and a C in one bra will be a D in another. What matters more than the assigned bra size is the way the implant looks on you. The best option for your body and aesthetic goals can be determined in a thorough implant sizing session.
Implant sizing depends on several factors. One of the most important factors is your breast width. Generally, your surgeon will measure your breast width, and then provide you with a range of implant sizes appropriate for your native breast size. There are more nuances to it than just what I've described, but this approach works for most women.
I usually have my patients bring in a large bra and a tight t-shirt to do sizing. I'll then choose 3-4 implants that I feel are appropriate, and have my patients place them in the bra under the tight t-shirt. My patients can then look in the mirror and get a good sense of what they will look like with the provided implant sizes. My patients like this approach and get a great idea of how they will look.
By using this technique, your surgeon can outline a range of appropriate implant sizes that will be aesthetically pleasing, and you make the final decision.
I hope this helps. Good luck!
Ideal Breast implants
No doubt you have already been told that your first step is consulting with a Board Certified Plastic Surgeon. Ideally, you will get a referral from someone you know who has had a good experience with her breast augmentation. From there, interview a couple of surgeons. By the time you finish, you will be comfortable in knowing that you've picked a size and a type of implant that fits your goals and lifestyle. It would be presumptuous of me to tell you that "425 mL midrange silicone gel implants placed under the muscle via the inframammary crease incision," is the answer to your question even though that may work for the consult I just saw. I hope that this helps.
Sizing Breast Implants
These are fantastic questions and ones I hear every day. Unless a special circumstance, as in revision breast surgery, I place most breast implants under the muscle. I feel this gives a softer, more natural appearance and a gentler slop from the shoulder blade down through the nipple...
We perform in office sizing with silicone sizers and an experienced nurse who helps consult with you and determine a range of sizes that will fit best on your frame. This range is initially fine-tuned by my physical exam measurements which objectively map out the width of your breast and determine what implant diameter will (and more importantly, which diameter/size will NOT fit your body).
Recently, I have also used a 3D imager, combined with the above techniques, to further aid patients in determining their idea size. We call it Precision Vision Fitting and a 3 D model is made of you (after 1 picture is taken) on a computer and different implants are placed hypothetically and Visualized on the computer screen....this allow you, the patient, to see what YOU would look like with a number of different breast implant sizes...REALLY COOL and patients absolutely love seeing themselves with their enhanced breasts.
I suggest that you see a Board Certified Plastic Surgeon with considerable interest and expertise in breast surgery who can help you with your implant sizing.
I hope this helps...good luck!
Determining breast implants to achieve the best results
Depending on the look you would like to achieve, I would recommend consulting with a Board Certified Plastic Surgeon. The most important part of having surgery is finding a well qualified surgeon to perform it for you safely to achieve the best results possible. During your examination, your plastic surgeon will let you know whether you are a good candidate for either saline or silicone gel implants.
Determining breast implants size and shape can be done using sizers. I would suggest finding pictures of the look you like to show to your Dr. For more information regarding breast augmentation, compare before and after photos of patients. Good luck.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.