What size is a 200cc, 300cc, 350cc, 400cc, 500cc, 600cc, breast implant?

measuring for breast implant size

Patients interested in breast implants often get locked in on the implant size instead of the actual breast cup size they desire. Since the beginning of breast implants, prospective breast augmentation patients attempt to research what they want by researching the implant size by cc volume instead of their pre-operative measurements. It’s easy to get mesmerized by cc volume as compared to a friend who already has breast implants, or by the array of breast augmentation photos across the internet.  What those photos often don’t include are the pre-operative measurements including true bra and cup size, the diameter measurement of the implanted breast implant, and the projection measurement.

Comparing apples to oranges is a huge mistake when researching breast implant sizes. To begin, most ladies are wearing the wrong sized bra. Ladies have been wrongly taught for decades how to properly measure for the best fitting bra. The biggest mistake is measuring ON-TOP of the breasts instead of just below the breast. That measurement gives you your accurate diameter. The cup size follow, but ladies need to understand that cups are not the exact same size from 32, 34, 36, 38, etc. measurements. A 34-D cup is not the same D cup size for a 32 or 36.  If you doubt this revelation, then we challenge you to go to a department store to compare a 34 D to a 36 D.  The 36-D cup is actually the same cup size as a 34-DD.  That’s why when you have shopped for a 32-B bra in the past, couldn’t find your size but the sales associate offers up a 34-A instead.  It’s never a good idea to wear a larger diameter bra according to what fits your cup because you will not benefit from that bra and its actual purpose: support. If your bra doesn’t fit you snugly around your chest, you just might be wearing the wrong size bra.

Now that we’ve explored the different bra cups, that means that a D-cup for 32-D, 34-D, 36-D, etc. are ALL DIFFERENT CUPS. Therefore, a C or D cup on you is not likely to translate as the same for all those pictures scattered across the web claiming a certain volume size implant is a D-cup result. The truth couldn’t be further from this fiction.

For instance, take a lady who was a true 32-A bra size prior to breast augmentation surgery.  This patient desired to be a small D. To achieve this result, the implant chosen was a 400cc saline implant.  Years later, this same patient decided she wanted to go bigger. To increase her bra size from a D to a DD, the implant size had to be increased at least 100cc to achieve this result. The actual volume ended up being 540.  This example brings us to another eye-roll in this industry: parsing implant sizes by 10 or 20cc thinking it will make a difference. Do not argue with your plastic surgeon over this little of a difference thinking it will actually make a size difference. It won’t.  All that means is that breast implants are available in these minor differences.

We’ve witnessed patients argue over implants sizes between 325 or 330.  Insert eye-roll here. There is so little difference between these two implants. They would amount to the same cup size. To change cup sizes, the implant volume would need to increase usually by 100cc. The larger the implant, the larger the increase is needed for a larger cup size.

Now let’s explore the hundreds of implant sizes available. Yes, I said hundreds. Why so many sizes? Because not everyone has the same size breasts, same size chests, and same goals according to desired cup size. Implants are chosen by your plastic surgeon first by a measurement made of your breast WIDTH. Implants come in diameter widths, projection profiles, and volumes. For example, say a patient is a 32-A pre-operatively. This patient desires to be a full c-cup. This patient’s breast measurement is 12 cm. For 12 cm, there are five different implants profiles to choose from with Natrelle brand silicone gel smooth round breast implants.  These profiles are Low Profile, Low-Plus Profile, Moderate Profile, Full Profile, and Extra Full Profile.  With a 12 cm measurement, the five different volumes that match that diameter are 230cc for Low-Profile which would be a B-cup result, 250cc for Low-Plus Profile also a B-cup result, 310cc for moderate profile, which may be a small C-cup, 365cc for the more common chosen Full-Profile which would be a C-cup, then 445cc for the Extra-Full Profile implant that would be more of a small D-cup.  However, for a patient with a larger beginning chest diameter measurement, these implant examples would be completely different to achieve the desired result. The purpose of this example to help describe the process of implant sizing according to the patient’s chest measurement. No one wants implants too narrow or too wide for their body. The implant chosen for you should be chosen according to your chest measurement, then choose the appropriate volume and projection to achieve your goal. Breast augmentation patients should not get hung-up on a particular implant size according to someone else on the web. A 500cc implant may be a full D cup for one patient, but for a patient with a larger chest diameter it may only be a C cup.  A 300cc implant may be a B cup for one patient, but for another patient who may have started with some breast tissue prior to surgery and different diameter it may equate as a C cup for them. It may also be two completely different diameters and projections.

What do I do to see if I want to be a B-cup, C-cup, or D-cup?

A B-cup? You can’t be serious. In my 20 years of managing a plastic surgery practice, no patient really wanted a B-cup. What they describe and show pictures of are usually C or D cups. The best advice I can give to help you decide what size you want to be would be to go to TJ Maxx and buy some bras that are one and two cup sizes larger than what you currently are. Such as, if you are a 34-B, then buy a 34-C and 34-D bra.  Next, go home and fill some plastic zip-lock baggies with uncooked rice. Fill four baggies until they fill the cups of the bras you purchased. You are likely going to need to fill them more or less until they fill out the cups with the bras on. Stuff the bras, put on a shirt and take some selfies in the mirror to compare the two different sizes.

Also in my 20 years of working in plastic surgery, the number one “regret” breast augmentation patients have is they wish they had gone bigger. Almost all breast augmentation patients initially think a C-cup is “big” or “huge.”  The truth is, most patients choose to be a D-cup.

Article by:

Pamela Howard

Patient Coordinator, Assistant, & Office Manager

The Saline Breast Implant Rippling Correction

Saline breast implants were added to the armamentarium of plastic surgeons in 1968.  It would take years and the removal of the first-generation silicone implants from the market in 1992 for the technology of the saline filled prosthesis to become a viable alternative.

The thickness of the silastic shell was the first problem along with the unnatural feel and the audible “swoosh” reported by women.  Eventually, a reliable shell was developed and overfilling of the implants became commonplace to improve the palpable rippling that tends to occur over time due to an evaporation-like effect of the saline solution.  This loss of volume causes the shell to collapse thus creating the rippling and is very common.  Saline breast implant rippling is often observed around thinner areas of the breast.

The problem with rippling was never corrected and continues to occur with virtually all saline implants as they age.  Rippling in saline breast implants is the most common cause for replacing implants for correction (breast augmentation revision).

Today, much more technologically advance silicone breast implants are available with a more natural feel and with improved ability to maintain their shape once placed in the body.  These implants come in a variety of anatomical shapes, and projections with at least three different stabilities. The stabilities refer to the implants ability to maintain their breast-like shape in the body.  The most “form-stable” made by Allergan’s Natrelle is called the “gummy bear” implant whose feel has been likened to a soft gummy bear candy.

Once a breast implant has resided in its pocket, usually beneath the pectoralis chest muscle for at least six months, the pocket becomes stable and rarely changes over its lifetime unless a capsular contracture occurs (<5%).  The loss of saline volume and rippling effect often gives the breast a saggy appearance but doesn’t always indicate the need for a breast lift procedure in conjunction with implant replacement.  In most cases, breast implant replacement with the gummy bear implant can fill-up the implant pocket and lift the breast back to a more desirable shape.

The painful part of the first breast augmentation usually results from the creation of space where there previously was none.  In a word, making the initial sub-muscular pocket at surgery hurts when filled with a breast implant.  Fortunately, once the pocket is made and is satisfactory in shape, taking an implant out and replacing it with a new silicone variety requires very little investment in pain.  In fact, it is such an easy recovery that we have called it a “Tylenol recovery.”

What you need to know before you go for your Breast Augmentation Consultation

My wife wrote an exceptional article regarding the breast augmentation consultation. Thought I would share . . . . .

The Plastic Truth by Pamela Howard

Choose your surgeon wisely

Choosing a surgeon who is Board Certified by the American Board of Plastic Surgery should be your first requirement.  A recent survey conducted by RealSelf.com found that patient satisfaction is 30% higher when patients chose a Real Board Certified Plastic Surgeon.  If you need more information about how to find a Real Board Certified Plastic Surgeon, read my article, or go to www.surgery.org.  Most surgeons will recommend you see at least three different surgeons before making a final decision. Some factors to think about when choosing the Plastic Surgeon:

How long have they been in practice?

Do they have before and after photos for you to view?

Is the office staff friendly?

Where is the procedure performed?

Does the surgeon spend adequate time with you?

Will the surgeon be seeing you for your post-operative care?

Know your correct current bra size

Most women are not…

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Introduction to Breast Augmentation

Breast augmentation with saline or silicone implants has become an increasingly popular option for women either born with a small chest or for those who suffer from the effects of child birth or have gained and then lost a lot of weight.  Breast imperfections coupled with the societal preference for a larger bust have caused breast enhancement to become one of the most frequently performed surgeries done by plastic surgeons.  The operation can be a challenge to perform as there are a number of decisions the patient and surgeon must make to obtain the best results.

The first and most basic decision is the choice of breast size and the possible need for a breast lift, or mastopexy, in addition to augmentation.  Next, the type of implant should be explored.  Some people desire the “natural” feel of silicone implants and others prefer the improved projection and lifting obtained with saline implants.  The surgeon will usually recommend that the implants be placed in the submuscular position (beneath the pectoralis muscle) although on a rare occasion sub-mammary (beneath the breast tissue and on top of the pectoralis muscle) placement is indicated.

Finally, the incision location is discussed.  There are basically four different incisions available: Axillary (armpit), Periareolar (around the nipple/areola), Inframammary (under the breast), and umbilical (through the belly button).  Most surgeons will know 2 or 3 of these approaches with the “TUBA,” or transumbilical approach, being the least performed incision due to the limitations of implant placement.  In many instances, the transaxillary approach is recommended due to its location in the armpit away from the breast itself, the quality of the scar in the hair bearing skin, and the fact that early implant manipulation to keep the implants positioned perfectly in the submuscular pocket without putting pressure on a breast incision.

Price shopping breast augmentation is a calculated risk as one is by necessity shopping a general anesthetic also.  Non-plastic surgeons performing breast augmentation are generally a “one trick pony.” That is, they tend to offer implants and rarely breast lifts (which are harder to do), nor do they offer a selection of incisions as the inframammary scar seems to be the easiest for the amateur surgeon to perform.

The caveat is to always check the credentials of your surgeon as there are no “weekend” courses to teach breast augmentation as there are for other procedures such as liposuction.  Also, beware of the “less is more” argument.  That is, minimal training as a “cosmetic surgeon” is somehow better than completing an American Board of Medical Specialties Board Certification as a real plastic surgeon.  Breast augmentation gone wrong is very difficult to reconstruct and shopping for the cheapest surgeon does not guarantee board certification, clinical judgment, or experience.

Dr. Paul Howard pioneered the use of the endoscope for less invasive breast augmentation surgery with the transaxillary (armpit) incision. 

Read more about top breast augmentation surgeon Dr. Paul Howard and his no-scar-on-the-breast breast augmentation.

About Breast Augmentation by Paul S. Howard, MD, FACS

Breast augmentation has been the most popular plastic surgery procedure among women for decades. Breast enhancement surgery can improve a woman’s image in clothing, swimwear, and overall figure. Breast augmentation mammoplasty is the surgical procedure to enhance the appearance of the breast with implants. These implants are surgically placed by creating a submuscular pocket for the implant. Dr. Howard does not prefer implant placement in the sub-glandular (on top of the muscle) position due to the un-natural appearance and the increased risk of capsular contracture (hardening of the implants).

Read more about top breast augmentation surgeon Dr. Paul Howard in Birmingham, Alabama.