Will 485cc smooth moderate plus silicone implants over the muscle be huge?

I am 5"4 and 145lbs. I am currently a 34C and would like to be a Dcup. My PS recommend a lift. I informed him i wanted implants but still want a natural look. PS recommended 485cc smooth moderate plus silicone obove the mucle. Possible mini lift during surgery depending on how the implant looks during surgery. It just sounds like a lot of CCs. It doesn't feel right and now I'm freaking out.

Answers from doctors (19)


Barry J. Kaplan, D.O.

Published on Jun 03, 2016

This will give you a 2 1/4 cup jump, which should bring you to a DD/DDD. Over the muscle is a disaster; there is a high rate of capsular contracture and sagging. The max I would recommend is 290 hi pro saline filled to 350cc, but you may need some lift.

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Answered by Barry J. Kaplan, D.O.

This will give you a 2 1/4 cup jump, which should bring you to a DD/DDD. Over the muscle is a disaster; there is a high rate of capsular contracture and sagging. The max I would recommend is 290 hi pro saline filled to 350cc, but you may need some lift.

Published on Jul 11, 2012


Ralph M. Rosato, M.D., F.A.C.S.

Published on May 31, 2016

Ask to see photos of another patient that is your size and shape with 485 cc implants. A 485 cc implant will add at least 2 cup sizes to your chest. A lift with smaller implants may suit you better. I would discuss it again with your surgeon.

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Answered by Ralph M. Rosato, M.D., F.A.C.S.

Ask to see photos of another patient that is your size and shape with 485 cc implants. A 485 cc implant will add at least 2 cup sizes to your chest. A lift with smaller implants may suit you better. I would discuss it again with your surgeon.

Published on Jul 11, 2012


Kenneth L. Stein M.D. FACS

Published on May 18, 2016

It sounds like your surgeon has a good plan for you.

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Answered by Kenneth L. Stein M.D. FACS

It sounds like your surgeon has a good plan for you.

Published on Jul 11, 2012


More About Doctor James Fernau MD

Published on Oct 15, 2015

In my opinion given your height and weight it seems like a rather large implant. However, I am a conservative surgeon. And, I place my implants underneath the muscle. You should have a frank and honest conversation with your plastic surgeon. Best wishes.

Answered by James Fernau MD (View Profile)

In my opinion given your height and weight it seems like a rather large implant. However, I am a conservative surgeon. And, I place my implants underneath the muscle. You should have a frank and honest conversation with your plastic surgeon. Best wishes.

Published on Jul 11, 2012


Paul Wigoda M.D.

Published on Oct 14, 2015

Without seeing photos of you its difficult to give you good advice. It really depends on what you want to end up looking like. Whats "really big" or "natural" to one person, is not to someone else. I show my patients photos of patients who have similar body types and breast size before surgery and what they look like after surgery with different size implants. I also use sizers during the consultation and have the patient look in the mirror to see what they can expect with different sizes. You should not be freaking out before your surgery. You should be very clear on what you will look like. If thats not the case, you need to spend more time discussing size with your surgeon or find a surgeon who is willing to spend the time with you. I rarely place implants above the muscle, especially if you want a "natural" look, and also if you may need a lift. Under the muscle would be better. If you are really a C cup, 485cc will probably make you at least a DD. Best of luck.

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Answered by Paul Wigoda M.D.

Without seeing photos of you its difficult to give you good advice. It really depends on what you want to end up looking like. Whats "really big" or "natural" to one person, is not to someone else. I show my patients photos of patients who have similar body types and breast size before surgery and what they look like after surgery with different size implants. I also use sizers during the consultation and have the patient look in the mirror to see what they can expect with different sizes. You should not be freaking out before your surgery. You should be very clear on what you will look like. If thats not the case, you need to spend more time discussing size with your surgeon or find a surgeon who is willing to spend the time with you. I rarely place implants above the muscle, especially if you want a "natural" look, and also if you may need a lift. Under the muscle would be better. If you are really a C cup, 485cc will probably make you at least a DD. Best of luck.

Published on Jul 11, 2012


Levi J. Young M.D.

Published on Oct 14, 2015

I understand your concern. 485cc's is a large implant that will likely make you a DD rather than D cup. I can understand that your surgeon may be trying to avoid the scars from a lift by using a larger implant above the muscle. You might consider getting another opinion from a board certified plastic surgeon. The best choice of implant should correlate with your base width measurements and your desire for size and shape. Find pictures of women on-line that have the look you want and started with a body type and breasts similar to yours. This always helps to show your surgeon what you desire for end result. Best wishes.

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Answered by Levi J. Young M.D.

I understand your concern. 485cc's is a large implant that will likely make you a DD rather than D cup. I can understand that your surgeon may be trying to avoid the scars from a lift by using a larger implant above the muscle. You might consider getting another opinion from a board certified plastic surgeon. The best choice of implant should correlate with your base width measurements and your desire for size and shape. Find pictures of women on-line that have the look you want and started with a body type and breasts similar to yours. This always helps to show your surgeon what you desire for end result. Best wishes.

Published on Jul 11, 2012


Thanks for your question. Firstly, if the 485 implant is a Sientra implant it shouldn't be used. The company has placed a voluntary hold on implanting any of their implants until a complete evaluation of the Silamed manufacturing plant in Brazil can be performed after microscopic particles were found on an implant surface. If you need a mastopexy of lift because of loose, excess breast tissue, it is in your best interest to have that procedure performed. You don't want to have breasts that are large and sagging, It's difficult to say if the implant is too large for your body without knowing your measurements.

Answered by Charles A. Messa, III, M.D., F.A.C.S. (View Profile)

Thanks for your question. Firstly, if the 485 implant is a Sientra implant it shouldn't be used. The company has placed a voluntary hold on implanting any of their implants until a complete evaluation of the Silamed manufacturing plant in Brazil can be performed after microscopic particles were found on an implant surface. If you need a mastopexy of lift because of loose, excess breast tissue, it is in your best interest to have that procedure performed. You don't want to have breasts that are large and sagging, It's difficult to say if the implant is too large for your body without knowing your measurements.

Published on Jul 11, 2012


Larry Leverett, MD, FACS

Published on Oct 13, 2015

Don't "freak out".
The size that looks best for you doesn't have to be the size that works best for someone else. You should trust your surgeon and his/her evaluation of your body contour, breast exam/asymmetries, and outcome wishes. Otherwise change surgeons. As far as the size goes, the limitation of the implant size is the width of the breasts and the quality of the breast tissue. In general, 200 cc's yields one cup size increase, but that is only a rough estimate. For taller people, its not quite a cup size and for shorter torsos, it may be more that one bra cup size. Also, the breast size varies with menses and normal monthly breast swelling, weight gain, and weight loss.
Regardless of the size chosen, the breast will appear to be too large for the first month or so. Otherwise, they will appear to be too little down the road.

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Answered by Larry Leverett, MD, FACS

Don't "freak out".
The size that looks best for you doesn't have to be the size that works best for someone else. You should trust your surgeon and his/her evaluation of your body contour, breast exam/asymmetries, and outcome wishes. Otherwise change surgeons. As far as the size goes, the limitation of the implant size is the width of the breasts and the quality of the breast tissue. In general, 200 cc's yields one cup size increase, but that is only a rough estimate. For taller people, its not quite a cup size and for shorter torsos, it may be more that one bra cup size. Also, the breast size varies with menses and normal monthly breast swelling, weight gain, and weight loss.
Regardless of the size chosen, the breast will appear to be too large for the first month or so. Otherwise, they will appear to be too little down the road.

Published on Jul 11, 2012


Charles Slack M.D.

Published on Oct 13, 2015

There are a couple of things that concern me beyond the implant size in your case. First would be if you really need a lift or not. Most patients are under the impression that implants will lift their breasts and that the bigger the implant the more the breasts will be lifted. They are under the assumption that putting implants in is like putting more and more air into an empty ballon, eventually you breasts will stand up like the balloon but this is not the case. In fact, overtime your implants may fall down into the excess skin below your breasts fold and further stretch your breasts out. This is particularly true for larger, heavier implants. If your breast skin is not able to hold its own weight up above your breast fold how is it going to hold an implant? If you need a lift you need a lift. In some cases it is not clear cut that a lift is needed. If a patient is boderline for needing a lift I will typically place the implant first and see how they like it with the understandng a lift can be done at a later date if they are not happy. Once you have ascar on your breast it is there forever. In my opinion a 485cc implant is too big of an implant fo you if you are already a C cup. I would consider something in the mid to perhhaps low 400cc range at most. This would depend on the width of your chest, desired height of upper polefullness form your infra-mammary fold and the amount of breast tissue you currently have. Finally, I prefer under the muscle placement in your case. This will give you the more natural look you are seeking and if you do indeed need a lift, in my opinion, under the muscle placement will better preserve blood flow to your nipple and breast skin.

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Answered by Charles Slack M.D.

There are a couple of things that concern me beyond the implant size in your case. First would be if you really need a lift or not. Most patients are under the impression that implants will lift their breasts and that the bigger the implant the more the breasts will be lifted. They are under the assumption that putting implants in is like putting more and more air into an empty ballon, eventually you breasts will stand up like the balloon but this is not the case. In fact, overtime your implants may fall down into the excess skin below your breasts fold and further stretch your breasts out. This is particularly true for larger, heavier implants. If your breast skin is not able to hold its own weight up above your breast fold how is it going to hold an implant? If you need a lift you need a lift. In some cases it is not clear cut that a lift is needed. If a patient is boderline for needing a lift I will typically place the implant first and see how they like it with the understandng a lift can be done at a later date if they are not happy. Once you have ascar on your breast it is there forever. In my opinion a 485cc implant is too big of an implant fo you if you are already a C cup. I would consider something in the mid to perhhaps low 400cc range at most. This would depend on the width of your chest, desired height of upper polefullness form your infra-mammary fold and the amount of breast tissue you currently have. Finally, I prefer under the muscle placement in your case. This will give you the more natural look you are seeking and if you do indeed need a lift, in my opinion, under the muscle placement will better preserve blood flow to your nipple and breast skin.

Published on Jul 11, 2012


Burr Von Maur, M.D., F.A.C.S

Published on Oct 13, 2015

Without looking at your photographs it's difficult to recommend the exact size implant or whether your need a breast lift. In general we recommend placing the implant beneath the muscle and judging from your height and weight, 485cc may be excessive. Again it's impossible for me to say without a current photograph, but if you'd like you're welcome to submit a photo to my online before and after visualizer tool--and we can better analyze your exact need: www.newlooknow.com/cosmeticare

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Answered by Burr Von Maur, M.D., F.A.C.S

Without looking at your photographs it's difficult to recommend the exact size implant or whether your need a breast lift. In general we recommend placing the implant beneath the muscle and judging from your height and weight, 485cc may be excessive. Again it's impossible for me to say without a current photograph, but if you'd like you're welcome to submit a photo to my online before and after visualizer tool--and we can better analyze your exact need: www.newlooknow.com/cosmeticare

Published on Jul 11, 2012


Remus Repta M.D.

Published on Oct 13, 2015

That does sound like a lot of volume for a one cup size increase based on your height. It may be because of the lift component. I recommend discussing this issue in more depth with your plastic surgeon since it may be that there is some miscommunication about what you would
like to achieve and what you may need to help you achieve that look. A breast lift and implants are designed to accomplish two different objectives and using one to help moderate the other is often a bad idea.

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Answered by Remus Repta M.D.

That does sound like a lot of volume for a one cup size increase based on your height. It may be because of the lift component. I recommend discussing this issue in more depth with your plastic surgeon since it may be that there is some miscommunication about what you would
like to achieve and what you may need to help you achieve that look. A breast lift and implants are designed to accomplish two different objectives and using one to help moderate the other is often a bad idea.

Published on Jul 11, 2012


More About Doctor Tom Pousti, M.D.

Published on Oct 13, 2015

It will be difficult for online consultants to give you accurate advice without photos and/or an examination and discussion of your goals.
Best thing to do is communicate with your surgeon. I ask my patients to bring in pictures of breast sizes that they like and even dislike. I review these photos with the patient and discuss if it is reasonable with their body type, size,etc.. I take these photos to the operating room with me and when the patients is on the operating room table, I use temporary sizers to view how different cc's look on the patient. I sit the patient up on the operating room several times and compare them with the photos that they have chosen. When I see that I have achieved the patient's goals, I remove the temporary sizers and put in the implants. There is no guess work. I have all sizes from both manufacturers available to me at all times. This procedure takes more time BUT gives more exact results.

Answered by Tom Pousti, M.D. (View Profile)

It will be difficult for online consultants to give you accurate advice without photos and/or an examination and discussion of your goals.
Best thing to do is communicate with your surgeon. I ask my patients to bring in pictures of breast sizes that they like and even dislike. I review these photos with the patient and discuss if it is reasonable with their body type, size,etc.. I take these photos to the operating room with me and when the patients is on the operating room table, I use temporary sizers to view how different cc's look on the patient. I sit the patient up on the operating room several times and compare them with the photos that they have chosen. When I see that I have achieved the patient's goals, I remove the temporary sizers and put in the implants. There is no guess work. I have all sizes from both manufacturers available to me at all times. This procedure takes more time BUT gives more exact results.

Published on Jul 11, 2012


Gerald Minniti, M.D., F.A.C.S

Published on Oct 13, 2015

I wholeheartedly disapprove of placing inappropriately sized implants over the muscle for the sake of lifting an already large and sagging breast. The majority of women are not satisfied: They are too big for what they wanted, and their breasts still look saggy. Many also end up with excessive and visible rippling and/or capsular contracture.
This nearly 500cc implant will make you much more than a D cup.
You should reconsider breast lifting. Please visit a few surgeons that specialize in all aspects of cosmetic breast surgery. Look at their photo gallery. You may be pleasantly surprised at the quality of scars. Most of my patients (and their spouses) don't even see their scars after a year, even when they are not so perfect. What drives a woman into discontent about her breasts after surgery is rarely scars, but almost always shape.

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Answered by Gerald Minniti, M.D., F.A.C.S

I wholeheartedly disapprove of placing inappropriately sized implants over the muscle for the sake of lifting an already large and sagging breast. The majority of women are not satisfied: They are too big for what they wanted, and their breasts still look saggy. Many also end up with excessive and visible rippling and/or capsular contracture.
This nearly 500cc implant will make you much more than a D cup.
You should reconsider breast lifting. Please visit a few surgeons that specialize in all aspects of cosmetic breast surgery. Look at their photo gallery. You may be pleasantly surprised at the quality of scars. Most of my patients (and their spouses) don't even see their scars after a year, even when they are not so perfect. What drives a woman into discontent about her breasts after surgery is rarely scars, but almost always shape.

Published on Jul 11, 2012


Stephen M. Davis, MD, FACS

Published on Oct 13, 2015

Ask your surgeon to try in-office sizers. Try on multiple shirts, sweaters bras etc and then you can more accurately decide if that volume is what you want. Make sure you understand the long term risks associated with larger sub-glandular implants.

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Answered by Stephen M. Davis, MD, FACS

Ask your surgeon to try in-office sizers. Try on multiple shirts, sweaters bras etc and then you can more accurately decide if that volume is what you want. Make sure you understand the long term risks associated with larger sub-glandular implants.

Published on Jul 11, 2012


David C. Yao MD, FACS

Published on Oct 13, 2015

Thank you for sharing. If you are concerned discuss your issues with your PS. Ask why the volume is needed. Ask why the implants area over the muscle. It is not possible to give a second opinion in an online forum. If the plan doesn't make sense after talking with your PS, consider a formal second opinion.

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Answered by David C. Yao MD, FACS

Thank you for sharing. If you are concerned discuss your issues with your PS. Ask why the volume is needed. Ask why the implants area over the muscle. It is not possible to give a second opinion in an online forum. If the plan doesn't make sense after talking with your PS, consider a formal second opinion.

Published on Jul 11, 2012


Andrew Trussler MD, FACS

Published on Oct 13, 2015

Choosing breast implant size is very individual, but anything larger than 400 cc moderate profile is on the large size. Larger implants do not lift the breast and larger implants can cause more sagging. Smaller breast implants with an appropriate mastopexy or breast lift is an appropriate procedure for natural breasts.

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Answered by Andrew Trussler MD, FACS

Choosing breast implant size is very individual, but anything larger than 400 cc moderate profile is on the large size. Larger implants do not lift the breast and larger implants can cause more sagging. Smaller breast implants with an appropriate mastopexy or breast lift is an appropriate procedure for natural breasts.

Published on Jul 11, 2012


David N. Csikai, M.D.

Published on Oct 13, 2015

It may not be huge depending on what you are looking for
Trying a sizer system can help also
You should probably discuss again with your surgeon or have a second consult

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Answered by David N. Csikai, M.D.

It may not be huge depending on what you are looking for
Trying a sizer system can help also
You should probably discuss again with your surgeon or have a second consult

Published on Jul 11, 2012


The Georgia Institute of Plastic Surgery

Published on Oct 13, 2015

First, go back and see your plastic surgeon until your questions are answered - before surgery - not after. Did they size you with implants in the bra? Your final volume is your present breast plus the new implants. If you are really a "C", and you add 485 - you will be large. Get a second opinion if you are not comfortable.

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Answered by The Georgia Institute of Plastic Surgery

First, go back and see your plastic surgeon until your questions are answered - before surgery - not after. Did they size you with implants in the bra? Your final volume is your present breast plus the new implants. If you are really a "C", and you add 485 - you will be large. Get a second opinion if you are not comfortable.

Published on Jul 11, 2012


Kristi Sumpter, D.O., F.A.C.O.S.

Published on Oct 13, 2015

Many patients can get too caught up on the size of implants in cc's. 485 cc implants can give a different appearance on different body frames. Do you feel confident in the way you and the surgeon are communicating and that she or he understands the result you want? If so listen to what is being said. Make sure what you want is understood. If any other part of the conversation makes you feel uncertain, take a step back and think it all through. Don't proceed if you're uncomfortable. However, if your surgeon is listening to you, understands what you want and is recommending that size, the indecision may come from preconceived ideas you had prior to meeting with your surgeon. For example if you have a friend that had the surgery, and she chose 350 cc implants and the result looks great on her, that may be molding your opinion even though you and she may have different body frames. Also regarding your result, listen and consider if a lift is recommended. Though it may not be what you originally planned and there is likely an increased cost, your surgeon is considering what your goal is. The last thought I have based on your question is the decision to have the implants placed above or below the muscle. Consider that aspect as well. I wish you well. The best part of these procedures for the patient is that these decisions are up to you.

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Answered by Kristi Sumpter, D.O., F.A.C.O.S.

Many patients can get too caught up on the size of implants in cc's. 485 cc implants can give a different appearance on different body frames. Do you feel confident in the way you and the surgeon are communicating and that she or he understands the result you want? If so listen to what is being said. Make sure what you want is understood. If any other part of the conversation makes you feel uncertain, take a step back and think it all through. Don't proceed if you're uncomfortable. However, if your surgeon is listening to you, understands what you want and is recommending that size, the indecision may come from preconceived ideas you had prior to meeting with your surgeon. For example if you have a friend that had the surgery, and she chose 350 cc implants and the result looks great on her, that may be molding your opinion even though you and she may have different body frames. Also regarding your result, listen and consider if a lift is recommended. Though it may not be what you originally planned and there is likely an increased cost, your surgeon is considering what your goal is. The last thought I have based on your question is the decision to have the implants placed above or below the muscle. Consider that aspect as well. I wish you well. The best part of these procedures for the patient is that these decisions are up to you.

Published on Jul 11, 2012


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