Choosing Your Size Most women who decide to have breast enhancement surgery are confused about how to “choose” their breast implant size. Some of the most common questions are: “What does a 300cc implant translate into cup sizes? ” “Is 500cc’s too big for me? Will 200ccs give me a ‘C’ cup? ” “My friend has 400ccs and she has a ‘D’ so I want 400cc’s too.” There are many factors that can determine what size breast implant will be needed to achieve your desired result. During your consultation at our office, photos of previous patients will be reviewed with you to find a few of your “likes/dislikes” – I find that communicating via photographs is much more accurate than discussing cup size and/or breast implant size. Looking at the photos chosen and discussing the goals with the patient allows me to determine if the patient has realistic expectations and understands the limitations of the breast augmentation procedure. Another form of communication is the Vectra 3D simulation software. A system captures a 3D photograph of the patient by using multiple cameras, and takes a number of photographs from several different angles, offering a 3D simulation of the patient. The software offers the opportunity for experimentation and discussion of different breast implant sizes and styles to give the patient more information regarding breast implant size and “an idea” of the look she is trying to achieve. We always let our patients know that the Vectra 3D imaging system is not a guarantee of the surgical results. Once the patient decides to proceed with surgery, she will provide her “likes and dislikes” and communicate her goals via photographs. Sometimes patients make posters and collages for clear communication. These photos and/or posters are placed on the operating room wall during surgery and are used as a reference for the ‘look’ the patient is going for. During the breast augmentation surgery, the breast implant pocket dissection is performed and a temporary sizer is placed. This temporary sizer is filled with air and adjusted as the patient is placed in an upright position multiple times during the surgery. This allows for adjustment of the breast implant pocket as well as the breast implant size to achieve the patient’s goals as closely as possible. Once the measurements and adjustments are made, the temporary sizer is removed and replaced with the correct breast implant size and style. Choosing a surgeon with experience is very important for any surgical procedure. Make sure you are comfortable with the communication with your surgeon. The more time you spend communicating prior to surgery, the more likely you will be pleased with the final outcome of the procedure. Cup Sizes For one, cup sizes are not consistent or set depending on the brand. For example, a ‘D’ cup at Victoria Secret can be a ‘B/C’ cup at Nordstroms. So when our patients come in asking for a certain cup size we recommend that they concentrate more on the ‘look’ they are going for. When doing your research for the ‘look’ you want focus on cleavage, outer fullness, shape (round, slope, etc), profile and size in comparison with the patient’s body. Saline vs. Silicone Saline and Silicone implants have the same type of outer shell but their contents differ. The saline implants are filled with Filled with a saltwater solution similar to the fluid that makes up most of the human body and silicone implants are filled with a memory gel that holds together uniformly. These contents affect the way the implant sits on the chest wall. In the picture below you can see that the silicone implant (green) molds to the chest wall while the saline implant (blue) sits on top of it. That is why a 200cc saline implant appears larger than a 200cc silicone implant in the patients breast.
Here is an example with Dr. Pousti’s patients.
Patient # 1-Saline
Patient #1’s breasts appear to be larger than Patient #2 but Patient #1 only has 375cc Saline while Patient #2 has 550cc Silicone. This is because of the way the implant sits on the patient’s chest wall.
CC’s with your Anatomy Don’t get too set on cc size either. The exact same size implants will look different on every woman, even if their anatomy seems to be similar. There are several factors that are taken into consideration before choosing the right implant size for you; height, weight, chest shape, rib size, breast shape, saline vs. silicone, breast volume, breast width, skin elasticity, sternal depth, and pregnancy history. Example: In the pictures seen below both patients started off with around a ‘B’ cup and post breast augmentation appear to have a ‘D’ cup.
Patient 1 Before/After
Patient 2 Before/After
Although it appears that the patient’s have the same size implant patient 1 has 525cc implants and patient 2 has 650ccs.
Patient’s that are same height and weight with same size implant and different results
Both of these patients are around 5’5″ and 110lbs and both have 300cc saline implants but patient #1 appears to have much larger breasts than patient #2.
How the Final Size is Chosen
During your consultation albums of previous patients will be reviewed with you. While looking at these albums a few of your likes/dislikes are copied so that the pictures can be placed in your chart.
Once the pictures are chosen Dr. Pousti has the patient write what they like/dislike about the patient’s breasts. Sometimes patients even make posters and collages. These pictures are taped up in the operating room during surgery so that they can be used as a reference to the ‘look’ the patient is going for.
After incisions and breast pockets are made, sizers are set in both breasts. A sizer is similar to a saline implant but is filled with air instead of saline.
Sizer in patient’s right breast
Once the sizer is filled to the amount of cc’s discussed, the patient is placed in a upright position and her look is compared to the pictures Dr. Pousti placed on the operating room wall. Adjustments are made if needed and then the sizers and removed and replaced with sterile implants.