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 that is often underappreciated is that of anatomy and starting point. Any implant will add volume to the volume that is already present—the implant is additive. A particular volume will not necessarily confer the same cup size to different patients. Often, 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 breast width diameter (BWD). This will ensure you avoid the dreaded "fake" look.

With regards to your specific question, "too big" is a relative question. The best advice is to respect your BWD. What may seem "too big" to one may not to another. It is important to remember small girls rarely have large breasts. Oversizing can lead to a mismatch of frame, which is often a hallmark of augmentation and the opposite of "natural." 600 cc is large on any frame. Regardless, as long as you are respecting your BWD, you should achieve a reasonable result.

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012

Yes, too large. Do you want to be very large, fake looking and don't mind appearing chunkier? This is a personal decision. Depends on your measurements, cup size, any ptosis (droop). A big factor is style of implant, and I believe you are talking about moderate profiles, which are inferior to high profile implants. There is about a one cup difference between the two sizes.

Published on Jul 11, 2012

650cc is large, but it depends on what you would like to achieve.

It's important to know what size bra you currently wear. Is it a 32, 34, 36 bra? What is your cup size? The strap size is important to know because that affects the diameter of the cup and the diameter of the breast implant that we choose. We also need to know your height, your weight, and it's helpful to know your dress size as well.

In addition, it would be very helpful if you include photos of yourself. A front view, a side view, and a three-quarter view are most helpful. This will let us see if there are any breast asymmetries, if the breasts are narrow, if the breasts are wide, what your chest wall looks like, and this will also help us make a decision as to the best size breast implant for you.

In my experience, in general, if a woman wears a size 36 AB bra and would like to be a C cup, which is the average size that women wear and the average size bra that is sold, she needs a volume of approximately 350 to 390 cc to make that change. This becomes less if she's wearing a 34 bra, because it has a smaller strap size and the cups have a smaller diameter. A smaller diameter implant would then be a volume of approximately 300 to 350 cc. In the same way, if she was more petite, maybe a double zero or size one and wore a 32 AB bra, then to become a 32C cup, she would only require about 250 to 300 cc.

This is a general number and, of course, there are other factors that will affect this. For example, if she has a chest wall issue where the chest is slightly sunken, this is called a pectus deformity, then she would require a little bit more volume to first bring her chest to a level position and then move forward to the projection of a C cup. This may require implants of about 50cc more. It's important to examine the patient and have complete information to make this decision.

Breast implant size:
1. 32A to 32C needs about 250-275 cc
2. 34A to 34C needs about 300-350 cc
3. 36A to 36C needs about 350-400 cc

Published on Jul 11, 2012

Thank you for your question. This is a difficult question to answer without examining your breasts. The implant you choose should be appropriate for your body frame and based on your breast base width, amount of soft tissue stretch around your breasts, and measurements from your nipple and areola to the inframammary crease below your breast and the length of your chest. The other consideration is the implant profile: moderate plus or SRM or high profile or SRF, depending on the implant manufacturer your surgeon uses. If you liked the appearance of that implant sizer on your chest, then I would recommend a large implant as long as your breast will safely accommodate that size. A word of caution though with larger implants: There is an increased chance for sagging over time, rippling, and neck and back pain. Take care.

Published on Jul 11, 2012

Only you can decide. I never push personal preference on a patient. If you tried on sizers and like the way they look, ask your surgeon to meet your request. I always warn my patients ahead of time, if the sterile sizers do not fit on the ribcage, or they merge together forming symmastia (or in layman's term, a "uniboob"), I will not use the implants. Instead, I'll size down to make sure there is not an anatomical deformity. The implants have specific measurements, and your surgeon should have measured you ahead of time. Assuming they fit logistically, if you like the look, I encourage you to ask for what you want! Good luck.

Published on Jul 11, 2012

There is over a 20% difference in size. One evaluates breast implants based on base width of the implant and projection. Speak to your plastic surgeon. To me, 650 cc implants, or 500 cc implants for that matter, would be too big for your frame.

Published on Jul 11, 2012

Hello and thank you for your question. I want to start off by telling you what I tell many of my patients: Do not focus on cc's or bra sizes as many women see their friend with "x" number of cc implants and think that they have an idea of what they want. There is a lot that goes into implant selection--your breast volume, the amount of cleavage you want to achieve, your base width, your rib shape/projection, etc. Without seeing you and doing your measurements, it is difficult to assess accurately your final breast size or shape. Please also keep in mind that when it comes to bra sizes, most women are not accurately sized for their bras.

The most important thing to consider is really the size and look that is appealing to YOU with the implants you choose. Many surgeons have sizing models, whether using bras with implants or computer simulation. I encourage you to discuss with your surgeon many of these considerations when deciding which implant and size to use during your surgery. Additionally, a breast implant is a round object and has a certain diameter. Your base width on each side of your chest will determine "how big of a ball" or what diameter implant you can reliably go up to with a socially acceptable cosmetic outcome. The implant will "augment" or increase the size of your breasts to an amount acceptable to you and your surgeon. There is no direct correlation with height and weight and base width, and you will need to know your personal measurement for the most accurate advice.

I have found great success having my patients try on a sports bra and then we pick the implants based on their measured breast base width. If your base width were to support, for example, up to a 650cc implant, I would have you try on the 650cc implants in the bra and then the 585cc or 550cc implants, and afterwards select the implant that made YOU the happiest. In reality, don't stress too much as this is not a HUGE difference and should be the fun part of the process. Go with what is acceptable based on your measurements and makes you happiest and make sure to weigh the pros and cons of the options you are considering. You can also compare the moderate profile with high profile implants and see which look you like most. The profile of the implant will determine how much upper pole fullness and overall projection you portray. In my opinion, in a young patient like yourself, high profile implants will give the breasts a nice shape for augmentation.

Make sure to seek consultation with a board-certified plastic surgeon with expertise in aesthetic breast surgery. I hope this helps answer your question and best of luck to you.

Published on Jul 11, 2012

650cc implants are somewhat large for a patient with your body size. Choosing an implant simply by how the sizer feels inside the bra is not the best way to choose. Seek out an experience plastic surgeon for an in-person evaluation to guide you in proper implant size and shape selection.

Published on Jul 11, 2012

Breast size is really a very personal matter. We have a unique imaging system where we scan the patients breasts and then show them how various shapes, sizes, manufacturers will look after the augmentation! Every about 120-150cc does increase the cup size by about one.

Published on Jul 11, 2012

It all depends on your frame and what your doctor explained about your chest size. It also depends on how much breast tissue you already have. You need to clarify that with your plastic surgeon. What you expect to look like post-surgery, it is best to be clear before surgery.

Published on Jul 11, 2012

Never. A 650cc implant is never appropriate for a cosmetic augmentation, and the same is true of 500cc. Implants of that size should only be used for mastectomy reconstruction.

Of course, that is just my opinion, and it is based upon looking at the sorts of problems I see in women with large implants. If you are considering a large implant, you should insist that the doctor show you long-term follow-up photos, such as 10 years after surgery. I have put in implants of that size, and the breasts look awful after a few years because the skin stretches and thins, the breasts sag, and then the patient often needs a more complicated revision and a lift.

As many plastic surgeons will say: no implants=no problems, small implants=small problems, big implants=big problems.

Published on Jul 11, 2012

Implant size/type is based on a number of things. Breast measurements, frame, tissue quality, and goals all come together to form the ideal implant choice. Your surgeon should be guiding you in terms of the implant that will do the best job. That being said, a 650cc implant is a pretty big implant for a 5'4 frame. That doesn't mean it isn't the right choice for you. Without an examination it is impossible to say. The average implant size around the country is in the 325-450cc range. I hope this helps.

Published on Jul 11, 2012

Choosing a breast implant size is very individual and made more individual with the selection of implant shapes. Volume of implants is an outdated language in modern breast enhancement. Think of 150 to 200cc as being a cup size, and think of anything over 500cc as being a very large breast implant.

Published on Jul 11, 2012

Ultimately, careful communication of your goals, as well as careful measurements (dimensional planning), will be critical. In my practice, I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of know words such as “natural” or "full D or DD cup” 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. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

Best wishes for an outcome that you will be very pleased with.

Published on Jul 11, 2012

Beauty is in the eye of the beholder. The larger the implant, the heavier the implant and the more effect gravity will have on it. Also, women that are petite may look heavy with very larger implants. It is best to discuss this with you surgeon. Good luck.

Published on Jul 11, 2012