I would like a second opinion: 470/450cc high profile round silicone. Too big or just right?

Question

I went in for sizing yesterday for a breast augmentation. My breasts are 12cm wide. I’m 5’1” about 125, but hoping to go down to about 115 eventually. We settled on 470/450cc high profile round silicone. However, I’m getting very scared that’s too big. Right now I wear a 32b (in Victoria’s Secret, which I know isn’t very reliable.)

Michele A. Shermak, MD · Answer

Hello!According to the info you have provided, you will have a very full breast after high profile implants. The implant choice depends on your size goal. Were you sized? You should have a very good idea of what the implants will look like on you, either by trying on implants or through virtual imaging techniques.Be sure you are comfortable with the surgical plan and contact your plastic surgeon. Women often request more than one sizing session to alleviate anxiety.Best of luck!

Leland Deane, MD, FACS · Answer

You should be very careful. I feel from your photos and your implant size plans that you are a setup for problems eventually. Keep in mind that it is important to keep the implant directly underneath the breast itself and not go beyond the borders of the breast, except in very specialized circumstances. Many of us feel that this is so key to a good result. If the breast pocket is 'over-dissected' you are at much higher risk for late and early deformities including 'bottoming out', implant displacement, and an un-natural look. You will have sacrificed shape for size.Can you have it all? Quite possibly yes, as long as you have a thorough discussion with an experienced surgeon. Imaging machines are useful communication tools in the right hands.I hope this helps.I'm available for further questions remotely if you want.

Kenneth Hughes, MD · Answer

The average implant volume placed in the US is 350 cc.  A very general estimate is that one cup size is 150 to 200 cc of volume, but realize that no direct correlation exists between the two.
None of the modalities to approximate final results from breast implants are 100% accurate; they merely facilitate the patient and the board certified PS concurring on the size and type of breast implant which will come the closest to reaching the patient's goal. When you consult in office with your PS again, ask to try on a profile bra with 470/450 cc HP round silicone sizers under a tailored blouse, tight sweater, swimsuit, 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.  I would recommend that you go with 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.

Gary M. Horndeski, MD · Answer

At size 32 A, each 100 cc of implant corresponds to 1 cup size.  450-470 cc implants would take you up 4 ½ cup sizes to a size F.  Also, those implants weigh over 1 lb each and will most likely result in descent.  The technique I recommend is a modified Benelli lift.  Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage.  At the same time, small implants or fat transfers can be placed.  Implants are not lifetime devices.  8% fail within the first year and 30% fail within six years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate for a breast augmentation. 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

Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  You are starting from a good position and should anticipate a nice result with an augmentation.  The sizing difference between 470 and 450 is very small in terms of a final result and I would try on sizers in your surgeon’s office in order to select the one you like best.

Daniel Barrett, MD · Answer

Dear danielerusek,
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

Adam Tattelbaum, MD · Answer

Thanks for your question and the photos. Picking an implant size is perhaps the most anxiety provoking part of augmantetion surgery.  I find it helpful to allow my opatients to try on actual implants in a testing bra in front of a full length miror.We focus on the balance of the curve of the breast with the curve of the hips and once we like the implants width we then look at different projections - high, moderate, low. I also find it helpful for patients to look with their own clothing- blouses, shirts and dresses.Given your height the implants you are looking at are generous for your frame, but it is about your goals as well. High profile makes a statement- moderate can be dressed up or down. See if your PS can have you try on sizers to give you a sense of comfort.I have included sizing faq in the link as well.Best wishes.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of former patients with similar measurements with different size and style breast implants. My patients tell me that this process is very helpful in determining what size breast implant is right for them. They also get to see what they would look like when the implants have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved.
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author                               
RealSelf Distinguished Hall of Fame Induct

Connie Hiers, MD, FACS · Answer

You have chosen fairly large implants for your size. I would recommend going back and trying on these sizes to give you a better idea of what you may expect and feel the weight of these implants. You might also want to try on some a little smaller as well.

I would like a second opinion: 470/450cc high profile round silicone. Too big or just right?

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