Choosing Your Size
For most women making the decision to get breast implants is easy but when i comes down to implant size most women don’t have a clue. “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 implant you will need to have your desired size.
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.
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.
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.
Saline implants have a silicone rubber shell that is inflated to the desired size with sterile saline. The implants are placed under the pectoralis muscle deflated and therefore, the incision used for this type of implant is minimal. These implants can be overfilled to achieve a more rounded appearance.
The FDA has approved the saline breast implants for breast augmentation / breast reconstruction surgery for all patients:
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
Saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference. Patients may need an MRI to diagnose a silicone gel rupture. Saline implants are also less expensive than the silicone gel implants.
Silicone implants have a silicone rubber shell that is filled with a fixed amount of silicone gel. Most silicone gel-filled implants are not adjustable and therefore, the incision used to place the silicone gel implant is larger than the incision needed for saline implants. The silicone gel implant cannot be overfilled – it comes in an exact size that cannot be manipulated.
Silicone implants vary in shell surface (smooth/textured), shape, profile, volume, shell thickness, and number of shell lumens.
Some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have. If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants. If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more natural result.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
Plastic Surgery Societies Applaud the FDA’s Decision to Approve Silicone Breast Implants
For Immediate Release: November 17, 2006
Arlington Heights, Ill. (November 17, 2006) – The American Society for Aesthetic Plastic Surgery and The American Society of Plastic Surgeons, the two largest plastic surgery membership organizations, applaud the FDA’s decision today to approve (manufacturer’s) silicone breast implants and return these devices to the U.S. market. This decision comes 14 years after the FDA restricted access to the silicone implants because of safety concerns. “This is a great day for American women and the plastic surgeons who care for them,” said Roxanne Guy, MD, ASPS president. “Silicone breast implants have been scrutinized more than any medical device, and we applaud the FDA for making its well thought-out decision and allowing American women to make informed choices about their health care.”
Today’s FDA decision follows a lengthy process in which the agency sent “approvable with conditions” letters to the two silicone breast implant manufacturers in the second half of 2005. The approvable letter stipulated a number of conditions that the manufacturers needed to satisfy in order to receive FDA final approval to market and sell silicone breast implants in the United States. These letters came after an FDA advisory panel hearing in April 2005, in which the panel heard more than 20 hours of data presentations from the manufacturers and public comment.
Approximately 300,000 women chose breast augmentation in 2005, according to ASAPS and ASPS statistics. Nearly 58,000 women had breast reconstruction in 2005, according to ASPS. Both breast augmentation and reconstruction have been proven in numerous studies to have psychological and physical benefits for women who choose these procedures.
The ASPS and ASAPS will continue to offer their assistance to the manufacturers for the conditions set forth by the FDA related to physician and patient education. One comprehensive example of this assistance is a joint Web site, breastimplantsafety.org, which offers objective and science based information regarding saline and silicone breast implants.
The American Society for Aesthetic Plastic Surgery (ASAPS) is the leading organization of board-certified plastic surgeons specializing in cosmetic plastic surgery. ASAPS active-member plastic surgeons are certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada. www.surgery.org .
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the Society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises more than 90 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. www.plasticsurgery.org