Can you make me a full C cup?

When they come in for their breast augmentation consultation, most women tell me that they want to be a “full C cup” and they want to look proportional. They think this means they will wear a C cup bra after surgery.

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Problem #1: There is no standard bra cup-sizing system.
“C cup” can mean one thing if it’s made by Victoria’s Secret and another if it’s made by Vanity Fair. You might wear a B cup in a full-coverage bra and a C cup in a demi bra, even if the same company makes both styles. Your cup size is also affected by how tight you wear your bra band. If you wear it tighter, it will push your breasts deeper into the cup and you will need a larger cup size.

Problem #2: What looks proportional varies from person to person.
I prefer to describe proportional as a “C look” instead of a “C cup.” To achieve the C look, a 5-foot woman with a small frame might only need a B cup while a 5-foot-8-inch woman with a large frame might need a D cup.

During consultation, I show prospective patients before-and-after photographs of women who started out similar to them in height, weight, frame size and breast volume. Every photo notes the size of the implants that I used. Women look at the pictures and tell me, “too big,” “too small” or “just right.” It’s like looking through a magic mirror into the future. A woman is almost always consistent as to the number of cubic centimeters (ccs) she likes, so I know what size implant to order to give her the look she wants on her body.

Screen Shot 2016-01-19 at 9.08.28 AMWhen we are finished the process, women almost always ask, “What cup size will I be?” This is where they can get into trouble. Again, the letter doesn’t matter. It’s a cup size look. They chose a look, and it looked right to them.

Here is an example of that trouble: A 5-foot-9-inch woman with a large frame wanted to be a full C. She liked eight different pictures. They all had the C look on her body type and were all the same number of cubic centimeters (ccs). I asked her if she liked the look, and she said, “Yes.” When I told her she would probably wear a D cup, she said, “I don’t want to be a D.” She was stuck on the cup size. She decided to go smaller and was disappointed after surgery.

A woman with a small frame also wanted to be a full C. After voting on the pictures, she asked for her final cup size. I told her she would probably wear a B. “Can you show me something bigger?” she asked. She had looked at larger implants, and she didn’t like the pictures that were even a tiny bit bigger. She decided to stick with the size she liked in the pictures, and was happy with her decision.

What implant size is equal to a C cup?
Breast implants are measured in cubic centimeters (ccs), not cup size. On a woman who is completely flat-chested and has a medium-sized frame, a 450 cc implant would be equivalent to the average C-cup bra.

Breast Implants – By the Numbers

1. In 2010, 1.5 million women around the world had breast augmentation surgery. About 300,000 of them lived in the United States, according to the International Society of Aesthetic Plastic Surgery.

2. Breast implants are measured in cubic centimeters (ccs) rather than cup size. On a woman who is completely flat-chested and has a medium-sized frame, a 450 cc implant would be equivalent to the average C-cup bra.

51oexEb-ArL._SY300_3. The largest standard saline implant is 775 ccs, while a silicone gel implant is 800 ccs. That’s equivalent to about 27 ounces, like this can of salsa.

4. The difference between a 375 cc and a 400 cc implant is less than 2 tablespoons – the amount of oil you would add to boxed pancake mix.

5. Outside of the body, a saline implant would freeze at about 28 degrees Fahrenheit, while a silicone gel implant would ice up at around 170 degrees below zero. Because your breast implants are close to your body, your natural body heat will keep them warm.

6. An implant’s silicone shell would melt at temperatures greater than 392 degrees Fahrenheit. A conventional sauna is typically between 150 and 190 degrees. If you were in an environment where your implants would melt, you’d melt, too.

7. If you get a pair of 350 cc saline implants, they’ll weigh about 1.5 pounds. If you get a silicone gel set, they’ll be closer to 1.7 pounds. To calculate how much your implants weigh, see below:Screen Shot 2015-07-23 at 9.09.52 AM

8. Breast implants are designed to be sturdy, and each manufacturer has its own testing protocol. Allergan tests its implants by exerting nearly 55 pounds of force on them repeatedly, up to 6.5 million times. By contrast, a routine mammogram exerts about 40 pounds of force when it compresses the breast, and if a woman had 50 mammograms in her lifetime, it would be a lot.

bag9. The TSA says that liquids and gels are safe to bring aboard an aircraft in limited amounts – 3.4 ounces or less. Thank goodness breast implants are “packed in your luggage,” so to speak, because one 425 cc implant is equal to about 14 ounces. It would be hard to squeeze it into one of those quart-sized plastic bags. To figure out how many ounces your implants are, divide the number of cubic centimeters in each of them by 30.

10. It’s rare for surgeons to charge more for a breast augmentation with larger-sized implants. Manufacturers don’t charge by the cubic centimeter either: They charge one set price for all off-the-shelf saline breast implants, whether they are 200 ccs or 600 ccs, and another set price (about $1,000 higher) for silicone gel implants.

Do breast implants need to be replaced every 10 years?

Several times a week in consultation, I answer questions like these:

“I need to replace my breast implants after 10 years, right?” Wrong.

Screen Shot 2015-02-13 at 10.42.02 PM“You did my breast implants 14 years ago and I’m still happy with their appearance, but a friend just had her 10-year-old implants redone because her doctor said she had to. Is that true?” False.

Breast implants don’t have an expiration date. They only need to be replaced if they deflate (saline) or rupture (silicone), and they’re not fragile.

It’s no surprise that women believe that implants have a shelf life, but what causes the confusion? Breast implants come with a free lifetime product replacement policy. Manufacturers also offer a 10-year warranty to defray some costs of implant replacement surgery. When women hear this, some assume they have to replace their implants after 10 years.

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Vintage refrigerator ad: Only new 1967 Admiral Duplex comes in 4 sizes, has the 5 features women want most!

Don’t be misled by the warranty. Your refrigerator comes with a warranty, too, but you don’t automatically replace it when its warranty expires. You’ll probably keep it until it breaks down, unless you are redoing your kitchen and want a bigger or smaller model.

Women sometimes opt to replace their implants for bigger or smaller ones after childbirth, weight gain or a change of heart. I recently removed saline implants from a woman who wanted to go bigger after 19 years, and her implants looked the same as the day I put them in.

About 1-3 percent of the 300,000-plus women in the United States who have a breast augmentation each year eventually have surgery to replace implants that have ruptured or deflated.

The most common reason that an implant breaks is because it develops a fold in one spot. Over time, that fold might move back and forth, weaken, and then break, in the same way that a paper clip might break after it has been bent multiple times. I’ve found that if an implant doesn’t deflate from fold failure in the first 6-7 years, the likelihood of this happening seems to decrease, not increase, over time.

Implant replacement requires time off from work, exposes women to the risks of surgery and anesthesia, and may require some out-of-pocket expense. As far as replacing implants every 10 years, my philosophy is: “If it ain’t broke, don’t fix it.”