Choosing Breast Implant Size : Part 3 “25 cc is Nothing!” and Picking Extra Big Implants

Choosing breast implant size should be fun, but it does requires some hard work. I call this “Do your homework!” This means that you need to put effort into learning the best way to pick your size. This is part 3 of the educational writings on choosing implant size for augmentation. It is important to read the other two parts as they will help you immensely in this decision process. The writings are written by me to help you in this big choice and to help you be happier and more satisfied with your results.

“25 cc is Nothing!”

As you narrow your final decision for your breast size, you ultimately have to pick a volume. Implant volumes are in cubic centimeters or cc’s. This is the same as milliliters or ml’s. But classically the volume for breast implants is in cc’s. The implants come ever 25 cc. For example, implants between 300 and 400 cc are 300, 325, 350, 375, and 400 cc. So there are just 5 different implants from 300 – 400 cc. For most women who are picking a C cup size, they would pick one of these. This, of coarse, depends on your specific anatomic measurements that I would take. The volumes will vary if you are larger compared to women who are smaller. But for the average sized women with normal measurements, the C cup implants are between 300-400 cc. The 300 and 325 cc volumes can be thought of as small C cups. The 375 and 400 cc as large C cups. 350 cc might be considered a classic middle C cup implant.

As you finish your homework, you will have to decide on a number or a volume. This is done with my close guidance. You might have to decide on 375 versus 400 cc. Remember this however, 25 cc is nothing! If you pick 375 cc and a twin sister picked 400 cc, you could not tell the difference. It’s just a very small volume change. The 25 cc volumes do add up gradually, so the difference between 300 cc and 400 cc is very noticeable. But with just a 25 cc difference, it is hard to tell the implants apart. If you hold up a 375 cc implant in one hand and a 400 cc implant in your other hand, you most likely can’t see the difference or it’s hard to see it.

I try to say the same thing in different ways or give additional scenarios to enhance the point or concept I’m trying to make. To point out how small 25 cc actually is, let me describe this situation. If you pick a 375 cc volume implant, and after you heal you find your result is too small, it’s important to understand that 400 cc was NOT the answer. Even 425 cc most likely was not the answer. Larger volume changes are necessary to see a difference, to be bigger and fuller, and to be happy with the result. Conversely, if you pick 375 cc and think you are too big, then 350 cc was not the answer. Probably 325 cc is not the answer either, as larger volume changes are necessary to see the difference or a change.

The “Goldilocks and the Three Bears” Method:

Having learned about the volumes and that 25 cc is nothing, I will describe a situation that can be helpful for those having a difficult time choosing. Let’s pretend a woman is finishing her decision on her augmentation, and she wants a middle to large C cup. She’s thinking 350 cc to 400 cc. She might feel a 350 cc would be a middle C cup and 400 cc would be a large C cup. Some patients are simultaneously concerned or worried about being too large AND too small. They are worried about the result being wrong on both the too big side and on the too small side.

In this scenario, I will say remember the fable Goldilocks and the Three Bears. One chair was too big; one chair was too small, and the final one was JUST RIGHT! So, if 400 cc seems like it might be too big, and 350 cc might be too small, then 375 cc is “just right for you.” We just learned that 25 cc is nothing or a very small volume. So in this scenario, 375 cc is just right and is often the final and best decision.

I Want to Go Extra Big. How Big Can I Go?

There is a limit on how big a women can go at one operation with breast enhancement. The tissues and muscle will only stretch so far. Picking too big a size can increase problems and risks. I will now describe a scenario to help patients understand big implant sizes. I will reference implants in terms of common objects, because it’s easier to understand and visualize then talking about cc’s. Imagine a women who picks implants as big as a basketball. This huge size would obviously not be possible in one operation, and if you tried, you can almost guarantee problems. But implants the size of volley balls would also be too big at one operation, and they would most likely lead to problems.

Small implants the size of oranges would definitely be possible or doable. So as the implants get bigger, the risks and problems go up. There is no exact number or size that is safe where smaller is ok and bigger is not. It’s a concept. Big implants have bigger risks because of shape issues. Extremely large implants can tear, over stretch, and injure tissues. One medical study showed implants bigger than 425 cc had increased problems. But the study over simplifies the results. The answer is not that 425 cc is good, and larger implants are bad. It’s the idea that is important. If we choose too big, risks are increased. The risks predominantly center on shape issues or having unusual appearances after surgery. Most patients can get implants up to approximately 500 cc. This is obviously dependent on her measurements and body size. Implants bigger than 500 cc are potentially more risky with shape issues and re-operation. Smaller ones would be considered lower risk and safe. For those interested in more information on extra large implants, risks, and safety, you can link to another educational writing now.

Some patients will ask, “So 500 cc is safe, but 550 cc is dangerous?” It’s not that simple. It’s not about being dangerous but about minimizing risks. Any problem that requires re-operation would have expense. We want to have safe surgery. As the implants get bigger, the risks go up. The vast majority of sizes are not a problem. As we go above 500 cc, we might want to consider planning on two operations (the size of the patient is a factor as I have said). This is called staging. Staging can maximize safety and results. Staging can help us get the bigger sizes we might want when large implants are desired.

What is Staging?

Staging is the planned decision to have two operations to achieve extra large sizes. The operations are spaced about 3-6 months apart to allow for tissue softening, stretching, and safety. People choosing DD or DDD cup sizes and other large sizes need to understand and consider this approach. As described above, the placement of extra large implants at one time or operation would have higher risks. Instead, two operations are planned. At the first operation a moderate size implant is used that is meant to be temporary. 3-6 months later, after the tissue has stretched, the final implant and a much larger one is used. This allows a women to get the size she originally wanted with less risk and less chance of shape issues. Staging is an excellent option for women who know they want extra large sizes, but they want to be safe and have lower risks. “Staging for safety” is covered in another educational wring that you can link to now.

Be Relaxed!

Making an important decision is best done with low anxiety and good education. Do your homework. I will work closely with you, so you will be very educated about the augmentation surgery, the recovery, and the risks. You must try to be relaxed to make the best decision about implant size. Excessive anxiety leads to a higher chance of dissatisfaction and unhappiness with results. It’s not always easy. But every patient must try and be relaxed to make the best decision and choice.