I am 34, no children, 5’8” 120lbs, BMD ranges are:R 11.1-12.0 and L 11.1 to 11.8. (This depends on menstrual cycle and when it's measured.) He originally planned to do HP 300cc Mentor Gel, then changed to the newer implant Mentor HP Xtra 285cc. I am concerned the implant will be smaller than I want. I don’t want a big, fake look but a nice, full, bustier appearance with some upper pole fullness and cleavage. The assistant stated anything higher would look like torpedoes on me. please help.
Defer to an in-person examination, but just based on your stated BWD measurements, you could tolerate a larger implant than that while still respecting the breast footprint. Depending on your shape and tissue characteristics, fat grafting may be a good addition for more upper pole fullness and cleavage if you'd like to be larger than that. The sizing process should leave you and the surgeon feeling confident in the size you choose, so if you're not confident ask to discuss more. I often find with my patients that trying on sizers is helpful to understand what they will look like and what their proportions will be.
Published on Jul 11, 2012
Both sizes you are considering are very conservative. The difference between a 285 cc and 300 cc is only about 1 tablespoon of volume. In my experience, the majority of revision breast augmentation patients are undergoing the surgery a second time to get bigger implants.
Published on Jul 11, 2012
I ask my patients to bring photos that depict what they want to look like after their breast augmentation. While they are under anesthesia, I insert temporary implants called sizers while the anesthesiologist sits the patient up. I keep trying different volumes and shapes until I find the one that best resembles the photos on which we have agreed. Then, the sizers are removed and the permanent implants are inserted.
Even if your surgeon does not work this way, it might be beneficial to show him what it is that you are trying to achieve by showing him photos.
Published on Jul 11, 2012
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 underappreciated 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 that 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. This will ensure that you avoid the dreaded "fake" look.
With regards to your specific question, I would not worry about a 15 cc differential as this amounts to 3 teaspoons. This is a very subtle volume differential and is likely to make very little difference. The switch to higher profile device will create a more dramatic effect despite the slight volume loss.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Published on Jul 11, 2012