Q: Dr. Eppley, I am interested in getting fairly large breast implants. I am only 5′ 2” and 107lbs. I’m currently a 32A. I have been told that I would need multiple surgeries to get my desired size of 650cc. One plastic surgeon I consulted with suggested that I start with a 400cc implant and then have a second implant later to get to my size. My breast width is about 13cm. What is the largest implant (style and cc)that I can get based on my breast width?

A: There are some issues that you may be aware of when you place large implants in women with small breasts, primarily which is the stretching out of tissue support. This can cause some long-term problems such as tissue thinning, bottoming out and an increased risk of the need for revisional surgery. But I will assume you know these so I will answer your specific question.

Depending upon whether you are choosing a saline or silicone gel implant, there are different size consideration either of which would be a high profile style implant. I only use Mentor breast implants so I can only speak of those sizes. A 560cc high profile saline implant has a base width of 13.4 cms which can be maximally filled to 650cc. At maximal fill this will narrow its base to 13.1cm. For silicone Memory gel implants, a 650cc implant has a base width of 14.4cm.

As can be seen by these numbers, I do not know why you can not reach your desired breast implant size in a single breast augmentation surgery.

Dr. Barry Eppley

Indianapolis, Indiana

Q: Dr. Eppley, I am interested in getting breast implants. I am fairly small framed, some call me petite, at ‘m 5’0” and 102lbs. I’m currently a 32A cup size. I have had one consultation and tried on sizers and it seems like 550cc implants seem to be the best fit for me for the size I am after. I have been told that this is a large implant for my type of body but this is the look I really want. My goal is a 34 DD. With implants of this size would it be possible for me to get a teardrop breast shape despites the large implant size on my small chest? Two other questions, will my areola stay the same size and what is the best implant and incision to use?

A: There is no doubt that you are interested in a very large implant for your frame. While it is every women’s right to choice any size implant they want, there are many plastic surgeons who will not accommodate an implant size that they feel may lead to loss of breast tissue support in the long run. That being said, whether it is a saline vs a silicone implant, you need a high profile implant to accommodate that volume with the most narrow implant base diameter so it does not end up too far to the side getting in the way of the swing of your arm. I would lean towards a saline high profile implant because it can be placed through a small armpit incision and gives the most projection with the narrowest implant width. As the skin expands to accommodate the breast implant underneath, your areolar size will get bigger.

Dr. Barry Eppley

Indianapolis, Indiana