Any recommendations? I'm 115 lb, 5'6 going from 34 B to 385cc or 415cc?! Silicone gel subpectoral crease incision. (photo)

The max my surgeon has recommend for me is a 385cc implant however I prefer the projection of the 415cc, but fear they will end up looking extremely unnatural or will end up weighing me down with my petite frame. I am fearful with the 385cc I will wish I went bigger, although I seek a natural look I also feel I did not emphasize who much more voluptuous I wanted to become when going in for my consultation. I want to become a D-DD although it is hard to estimate based off of cup size.

Doctor Answers 12

The difference between those implants is negligable

Assuming that those implants would fit your frame based on the width of your breast, the difference is negligible. It's 2 tablespoons.  The last question I usually ask a woman before going back to surgery is "are you afraid of being too big or too small?"  If you were to say "too big," I'd use the 385cc implants.  If you were to say "too small," I'd use the 415cc implants.  If you got the 385cc implants and thought you were too small after surgery, I guarantee that you would not have been happy with 415cc either!  If someone is going to go back to surgery to increase the implant size, they usually would add at least 100cc to the implant.   So what should you do?  Accept that your breasts will be bigger after surgery and you'll look great.  Listen to your surgeon -- we are actually here to make sure you don't make mistakes that could impact you for the rest of your life.  If he/she felt that 385cc was the biggest they could do, I'd listen to them.  Good luck!

Columbus Plastic Surgeon
5.0 out of 5 stars 15 reviews

Any recommendations?

As Dr. Rottman explained, there are many different factors that go in to play when examining a patient and assisting in their decision.  This includes specific measurements that are done by a board-certified plastic surgeon that is skilled in breast augmentation and can advise the best implant size, profile, placement and incision that will give you the best outcome. Spend time trying on the sizers and see what they look like on you, but know that there is much more that is involved than just the size. Hope this is comforting and good luck with your decision!

John C. Pedersen, MD, FACS
Akron Plastic Surgeon
5.0 out of 5 stars 20 reviews

Breast Size

I would suggest meeting with your surgeon and really finalizing size details and specifications. Trust your Dr. but also make sure you're clearly communication your goals and desired size.

Best of luck!
Dr. Daniel Barrett MD
Beverly Hills Plastic Surgeon

Daniel Barrett, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 62 reviews

Breast Augmentation - Size Selection

Thank you for your excellent question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. Choosing an implant too wide or too large will lead to problems in the future which will require additional surgery. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery!

Steven J. Rottman, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 78 reviews

Recommendations for size: Going from 34B, 5'6 115 pounds

You have a nice shape and should get a wonderful result.  On my preop visit, a great deal of time is spent on refining the best size for the patient. Goal pictures, and 3 dimensional imaging are very useful to get a good idea of size, and then I find that having the patient spend as much time as they need with sizing implants with a minimally padded bra, and seeing how they look and feel with clothes on help make the final determination. Over many years, there is a trade off between the natural desire to look as full as you comfortably can with having implants that are too big for your frame, and will either look unnatural, or increase the risk of other problems that large implants can bring.  I would go with your surgeon's suggestions, but communicate your concerns once again.  There is very little difference between 385 cc and 415cc.  In my practice it is essentially unheard of for a patient to feel that they went too large after going through the careful choosing process, but it is not uncommon for patients to wish they were just a little bit larger.   On the other hand, the desire for larger breasts can be a bit like eating chocolate: it tastes very good until you have had one bite too many.

Thomas A. Mustoe, MD, FACS
Chicago Plastic Surgeon
4.8 out of 5 stars 95 reviews

Breast Augmentation Size

When I meet with my patients prior to breast augmentation surgery, size is the single most important topic we discuss. Most plastic surgeons will prefer a crease incision and below the muscle. The size can be determined by listening to the patient and using sizers in the operating room. This approach will be the most accurate.

Frank J. Ferraro, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 48 reviews

Which size is best?

Thank you for your question and photos. It is very appropriate to be concerned about what your tissue and anatomy can accommodate when deciding on an implant. However, the difference between 385 and 415 is quite small and unlikely to make a substantial difference in your result; if you felt your surgeon understood your goals then I would have confidence in his/her judgement and recommendations. I hope this is helpful.

Bryan Correa, MD
Houston Plastic Surgeon
5.0 out of 5 stars 15 reviews

What size implants

Go with the one that fits best according to the exam done by your chosen plastic surgeon.  Remember that there's always one larger than the one you picked until you get to 800 mL. 30 mL difference in a 600 mL breast which is your 200 mL  breast plus about a 400 mL implant is going to be very hard to see. Hope this recommendation helps. Good luck. 

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Any recommendations? I'm 115 lb, 5'6 going from 34 B to 385cc or 415cc?! Silicone gel subpectoral crease incision.

Thank you for your question and photographs. Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend you voice your concerns with your surgeon, they are in the best position to ensure that the implants the two of your decide upon are the right ones to meet your expectations. It sounds as if it may be wise for you to "try on" several of the implants so that you can have a better visual representation as to what they would look like. Best wishes!

Nelson Castillo, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 65 reviews

Breast Augmentation/ Breast Implants/ Anatomic Gummy Bear Implants/Silicone Implants/Revision Breast Surgery

I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.

Silicone will give you a fullness at the top (upper pole fullness).
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute

Jaime S. Schwartz, MD, FACS
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 91 reviews

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.