Not Sure How Wide to Go to Get a Natural Look

Hi there, I am 5'7.5" and 135 lbs with a 34-36 chest size currently wear a-aa cup size. I am scheduled to have surgery with a 350cc moderate silicone. I liked the way this looked in the Dr.'s office, just a little bit big, maybe. However my Dr. said that to get an hour glass figure I should go up 50cc. That felt huge and I felt too top heavy. On the other hand the 350cc didn't come out beyond my torso at the sides looking at my profile from the front. Will that look unnatural naked?

Doctor Answers 11

Breast Enhancement Surgery

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I dont like sizers that much I really dont think it reflects what the implants will look like when they are deep under your skin. Conservative is the key to long term success, go with the smaller implants they typically look better and last longer

Implant Selection Process

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In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.
Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

Breast implant size

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 Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.
3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.

Implant sizing

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The choice of implant size and shape is made based on your breast dimensions and your overall goals. The width of your breast and the amount of breast tissue you have dictate the range of implants that your breast can "naturally" conceal. The implant size and shape is then chosen from this range to meet your goals. For women with a-aa cup breasts, high profile devices work very well. These allow for larger volumes with narrower bases so that a larger breast can be achieved without going beyond the lateral boundaries of the breast. Remember that your surgeon likely has a lot of experience with breast augmentation and choosing implants. If you are unsure, see one or two more surgeons to get their opinions. Good luck with surgery!

David Bogue, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 26 reviews

Volume and proportion key to size success

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Hi Poppet,

There are 2 considerations. One is overall volume and the second is proportion/width.  Keep in mind that the implant will look slightly smaller inside your body.  So, you like the 350cc size in terms of volume and overall proportion.  If the width was not wide enough, talk to your plastic surgeon about using a lower profile implant.  This will give you the same volume with a wider implant dimension.  Also, 50cc is really not a big volume difference; most patients cannot even detect it.  Given your height, 400cc is not unreasonable.  You have a great grasp of the issues; keep asking questions until you feel comfortable.  Hope this helps.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

Implant choices

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It is difficult to say how they would look on you without a full exam and a review of what you would want.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast diameter measurement for natural breast

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A 50 cc difference in breast implant size is not likely to make a significant difference in appearance. Probably one of the more critical measurements is the breast diameter and you may want to select an implant that has a diameter that is 1-2cm smaller than your existing diameter in order to maintain the current breast width.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Not Sure How Wide to Go to Get a Natural Look

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Return to your chosen surgeon to discuss until you both are on the same page!. I would have liked to see a posted photo. But my recommendation with the little info is go 375cc as a compromise. From MIAMI DR. Darryl J. Blinski, 305 598 0091

Avoid Implants Larger Than Breast Width If Natural Look Desired

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I agree that it is important to avoid an implant larger at the base than your breast unless you are willing to accept "the fake look".  I think that it is acceptable to use an implant slightly smaller than your breast width, however, especially if it is a smooth round implant as it will tend to move around the pocket a bit.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Sizing of breast implants

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Choice of implant size (volume) is based on your anatomy, how much breast tissue you have to cover the implants, what is your breast's base diameter. Once this is established, you can see what implant projection might be desireable for you. A nulliparous woman (no previous pregnancy) tends to have a tight skin envelope as opposed to someone who went through a pregnancy. A low profile implant would be fine in the first case. A cup size is about 150-200cc. I do not believe that you should worry about going up 50cc (1/4-1/3 of a cup size). You want the implant that will fill the breast pocket, but without overstretching the skin envelope. Good luck with your surgery. 

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.