445cc vs. 485cc moderate plus silicone? Is there a noticeable difference between these two sizes?

Dear cara bartkoski,
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

Hello, thank you for your question. A board certified plastic surgeon will be able to guide you to the correct size implant. Based upon measurements of your chest wall and breast imprint width as well as knowledge of all breast implant sizes and profiles should make this process easy. Try on a profile bra with various silicone sizers your PS recommends under a tailored blouse, tank top, bikini, workout clothes, and other garments you typically wear so that you have the best idea of whether the garments fit as desired with the implant selected. Select the size that boosts your self-esteem, and fits your anatomy. Choosing an implant based on an aesthetic goal that exceeds your anatomic capacity may lead to complications and possibly revision later in life.

The difference is less than 3 tablespoons so will not be noticeable. To go up a size would require about 100 cc's. Consult with a board certified plastic surgeon to learn what options are available to you! Good luck. 

Hello and thank you for your question. There is no significant difference between these two sizes to justify the exchange procedure. Generally speaking, you would require at least 100-150 cc larger implant for a noticeable increase. Best,

Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

The sizes you are deciding between are very small and would not be very noticeable.  Once we narrow down the sizes I focus on the measurements and look at the implants more to fill a measurement than a volume.So we look at the measurements we have taken and see which implant size would maximize the patients results without going over the measurements.  Therefore, if the patients width allows for the larger hence wider implant then that is the implant that is chosen to help maximize the patients cleavage and bring the breasts close together, if that is what the patient desires.Hope that helps.

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  The overall difference between 445 and 485cc is very small.  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.   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.  FACS

Harvard-trained plastic surgeon
 

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD.
Patients are discouraged from struggling over small differentials as this rarely makes a significant difference in outcome (40 cc is slightly less than the volume of a shot glass).
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

There is not much difference between the two sizes. If you currently have the smaller, I don't advise changing to the larger. It won't be worth the time and expense of surgery for only 40 cc's.

There are 4 basic questions that need to be answered before breast implant surgery:
Location of scar (incision)Above or below the muscleType of implant (saline/silicone, round, anatomic, high profile)Size of implantThe hardest decision to make, BY FAR, is the size and style of the implants. Choosing implants based on projected bra size is a poor way to choose the size of the implant.  The choice should be made based on the look that you want and then you can find a bra to match.  It is not about bra size, it is about breast appearance. 
Based on your desires, you should be able to achieve your wish look.  I would choose the larger size. Please see a board certified plastic surgeon who performs breast implants frequently to help with your decisions.
Good luck!

Hi and welcome to our forum!A 40 cc difference equates to a little more than a shotglass full of saline (standard shot is 30-37 cc). However, when choosing among various breast implants, the width (base diameter) and projection (profile) are equally important. Your surgeon has measured your chest wall and will offer suggestions based upon your examination. One's eye can usually discern a 60 cc difference in breast volume in the average size breast.  The larger the breast size, the less noticeable the change will be.Best wishes...