Very active, want to maintain a streamlined, natural look without restriction during workouts. 36AA to A, full B cup? (Photos)

Question

I am currently an 80A (36AA), 164cm, 65kg with a very lean/athletic base. I’m scheduled for a breast augmentation using Motiva Ergonomix2 Demi (E2SD) with under the muscle placement. My surgeon recommended 360cc, and while the 3D simulation looks natural and fits my 12.1 cm Breast Base Diameter (BBD) perfectly, I’m worried about the volume. I am very active and want to maintain a streamlined, natural look without feeling "too big" or restricted during workouts. My surgeon also ordered 325cc and 335cc as backups. On an 80/36 frame, will 360cc push me into a C cup, or will the Demi profile and muscle coverage keep it looking like a full A or small B? Has anyone with a similar BBD and active lifestyle regretted going with 360cc?

Franklin D. Richards, MD · Answer

The implants chosen by your plastic surgeon seem very appropriate for your goals. There is only minimal difference between the 325cc and 360cc. I have found the best way for a patient to be happy with the size of the implant is to utilize pre-operative sizers from the manufacturer. These placed in a bra and observed in a mirror prior to surgery gives the patient a very accurate estimation of the size that will be obtained.

Gary M. Horndeski, MD · Answer

At size 36, each 200 cc of implant corresponds to 1 cup size change. 360 cc implant will take you up more than 2 sizes. They may not fit underneath the muscle and may require release of the attachments of the 5th and 6th ribs and this may result in the implants extruding inferiorly and laterally. The larger the implant the large the mechanical load. I recommend smaller implants.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Zoran Potparic, MD · Answer

With your frame it is an average of 150-175 ml that represents one cup size. So, so if you want to go 2 cup sizes up a volume around 300 ml  should be considered. We did not find Vectra 3D simulation to be very useful in selection of implant volume. Good luck.

Donovan Rosas, MD · Answer

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.
With regards to your specific question, it is impossible to predict cup size with any certainty. Your choices seem reasonable. The size variation is subtle and unlikely to make or break the result.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Daniel Barrett, MD · Answer

Dear Gweny10,

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

Ted Eisenberg, DO, FACOS, FAACS · Answer

The difference is small and should not affect your workout abilities. Therefore, choose what you like. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Camille Cash, MD · Answer

After you are healed from surgery you will be able to return to your active lifestyle.  The implants you are considering should look nice on you.  However you will be larger than a full A/small B.  Many surgeons have sample implants available that you can "try on" to give you an idea of how you may look after surgery.  I encourage you to discuss your concerns with your surgeon.

Very active, want to maintain a streamlined, natural look without restriction during workouts. 36AA to A, full B cup? (Photos)

Answers (7)

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