Anxiety over Breast Augmentation

[AlyssaJ]

Hey everyone, yes it's been a long while since I've posted.  Been pretty focused on just settling into life after going full time, going through divorce, new job, etc.  Anyway, I'm at the point now where I have the insurance and finances to start pursuing surgeries as part of my transition. I've had a few initial consults for breast augmentation and I've chosen a surgeon and set a date in early January for the procedure.

Like so many, I'm worried about picking the right size implant and it's starting to cause me some anxiety. Right now I'm at a 36B. My breasts are wide-set and a bit V shaped (narrower at the bottom then widening out as you move up my chest).  I went in multiple times and played with sizers and based on what I was seeing 325-350cc seemed to be the right range for me so my doctor is ordering a range of implants in those sizes.

However, I'm starting to worry that I may be going to small. I was hopeful to get in the ballpark of a D-cup.  However, after looking at people on real-self, watching some you tube videos, etc. I'm seeing women with similar dimensions getting anywhere from 400-600cc implants.

In talking with my doctor, he felt anything over 400 was so exceedingly large for my body that he said he would not do the surgery if I wanted to go that large. He is also looking at a size chart from the implant manufacturer that says for my breast width (12 cm), a 325cc implant is already a high-profile implant. So going up much from there may lead to a very unnatural appearance. For reference, the plan is to use round silicone implants placed sub-glandularly (over the muscle).

I'm looking for thoughts from those of you who have had BA's done. Is there anything you can tell me to alleviate my anxiety?  Do you think I'm making a mistake and should push for a larger size?  I appreciate anything you can share.

[Linde]

I have not done any implants, but I was one of the original developers of implants.  Why would you want to have an implant on top of the muscle?  It always shows up to anybody looking closer that something is kind of floating around under your skin.  Also, most of the times, the scar will be way more visible, because it sits higher on your breast.  I would think that one over!

On the size, you should try to look as natural as possible.  How are the closest female relatives with their breast sizes?  You should thrive for a similar size they have, because that would look most natural!.  Also remember, when you get big boobs, you have to carry them around all day long, every day.  Many well endowed cis women complain about back aches because they have to carry that weight around on their front!

[jill610]

Oh dear, I was where you are a few months ago and have the thread to prove it. You will be fine.

On size, you have to go with your surgeons advice and your gut. I went one size up from the recommendation and couldn't be happier. As trans women we tend to have wider shoulders and the larger implants help to balance that out.

I thought I wanted to be a "C" however after consideration and seeing the 3D models, it wouldn't look right. I was a 34A and got 520cc round textures places sub muscular. After two months, they have mostly fallen into place, are starting to soften and look fairly natural. I am now a 34DD which is a scary number but in reality is proportional to my frame.

I agree with the question, why would you want sub glandular? It will not look natural, will sag and you will visibly see the implant through your skin. Submuscular is more painful for the first week but then is fine. I was pain free at week 3 and full range of motion on day 3. It will never really have the natural sag over the crease but will not see the implant. My surgeon says 99% of the implants he does are sub muscular.

[SpiralCream]

Subglandular implant also increases the risk of capsular contracture compared to submuscular.  In addition to increasing the chance of rippling, worse aesthetics, and less realistic feel.  Almost all BA surgeries these days are submuscular. I also question why your surgeon is wanting to do subglandular.

Also, 325 cc at 12 cm BWD is NOT high profile. I don't know what chart your surgeon is looking at, but the Mentor implant sizing chart shows that to be a moderate+ profile, not high profile.

[SpiralCream]

Here is the sizing chart for Mentor moderate+ implants.  As you can see, 12 cm at 300 cc and 12.3 cm at 325 cc are moderate+
https://www.justbreastimplants.com/article/breast-implant-size/memorygel-siltex-round-moderate-plus-profile-implants

And here is the sizing chart for Mentor high profile implants.  High profile at 12 cm is 375 cc.
https://www.justbreastimplants.com/article/breast-implant-size/memorygel-siltex-round-high-profile-implants

I had BA surgery myself, just 4 weeks ago.  I had the same breast width as you, 12 cm, although my bra band size was 34 (so my breasts were not wide set compared to yours).  I had not-quite-an A cup, and I wanted to go to a C cup.  I ended up getting 375 cc Mentor high profile implants.  I think they may be a bit bigger than I wanted, but oh well.  During my consultation, I asked the surgeon if 300 cc moderate+ implants would increase me by 2 sizes.  He said they would increase me by 1+.  So maybe, maybe not.  I decided I never wanted to wear padded bras again so I went bigger, lol.

Your body can definitely handle more than 325 cc, if that's what you want. 

[AlyssaJ]

Regarding the placement, that is based on my Doctor's recommendation.  He said initially they used to always do sub-glandular.  Then Sub-Muscular placement came along and the risks of capsular contracture were so much lower that at that point he switched to doing sub-muscular almost exclusively.  He said now, however, he uses a much newer technique for sub-glandular that doesn't have the same risks and results in more breast material covering the implant. After measuring my breasts he felt I had enough tissue to provide sufficient coverage to prevent rippling or showing of the implant.  He also wanted to avoid submuscular placement with me because of my physical activity. Given my involvement in sports and physical fitness, he feels it would be safer to avoid movement by going subglandular.

Jill, stories like yours are what worry me.  I have a fairly large rib cage and broad shoulders, so when I hear of women going to DD sizes and feeling it looks proportional, I get nervous.  From what I can tell, 350cc implants with my current physique will result in a large C or maybe small D.   

[Colleen_definitely]

My surgeon says that has had really great results from sub glandular placement of cohesive anatomical "gummy bear" implants.

And after getting to play with a couple implants (outside the body) I have to say they're pretty darn neat.

Honestly I would trust your doctor's judgement on the size.  A big C or small D is quite well above average for a physically fit girl.

[Michelle_P]

I had my surgical consult last month.

I'm a 34 A-B, and not that big, at 5'7", 135 lbs, 29" waist, 36" hips.  Breast width is 14cm.  Our best guess from sizing was that I should try 275-325cc implants, submuscular. 

I want to maintain my fairly thin appearance without becoming too 'topheavy', but while still looking reasonable in most scoop or v-neck dresses.  I don't mind using the 'right' bra for special effects on occasion.

I'll be using the round lightly cohesive gel implants.  The rough textured high cohesion implants don't 'flow' as well between vertical and horizontal positions, and have an increased risk of an unusual cancer.  The submuscular placement generally looks better for women with my frame and breast size.

I have my surgery scheduled for late March, to be done in conjunction with labiaplasty revisions from my GCS last year.

[jill610]

Jill, stories like yours are what worry me.  I have a fairly large rib cage and broad shoulders, so when I hear of women going to DD sizes and feeling it looks proportional, I get nervous.  From what I can tell, 350cc implants with my current physique will result in a large C or maybe small D.

Consider that an average cis woman with a 34 chest would be 5'5. I am 5'10. My clothes fit perfectly and looking in the mirror I thought I was a C up until I got sized.

The DD frightened me but for my frame it is proportional and perfect.

Note that I saw 5 surgeons because I don't trust any single surgeon, and then made sure I found one I was comfortable with. If the five, only one recommended sub glandular. All recommended in the 460-520 range for me.

[Kendra]

I am 5'7" (170cm tall) and had 350cc Mentors installed under the muscle July 2018, very happy with the results.  36C or 34D depending on brand.  Before BA I was an A cup.  But I don't want others to conclude this is a good size for everyone at this height.  I asked my surgeon for a smaller size than her initial recommendation and ended up at 350cc.  In addition to ribcage width there are other personal factors I considered: I enjoy physical activities, half Asian, and still growing - started HRT exactly one year before BA.  I found breast growth accelerated after switching from estradiol patches to injections with theoretically the same dose.  If I grow a cup size (or not) in the next couple years I am fine with that.

Depending on goals and other factors, quite a bit larger might also be fine.  My surgeon mentioned if there are any regrets, it is usually from going too small.  Personal decision for each of us.


30 days after breast augmentation

[GordonG]

Kendra
Wow, you look amazing!

[Kendra]

Awwww - thank you!  Yeah I'm very happy with my decision.

[Harley Quinn]

My best advice is to look at your surgeon's portfolio and base your decision on how his results look; as well as on how many trans women he's worked with. If the surgeon isn't comfortable with a particular size, I'd find another surgeon, or go with their recommendation. No surgeon is going to want to do a bad job, its bad for business. I don't think it wise to push them outside their comfort zone... they know what they can and can't do to get good results.

[jill610]

I also heard the statement that most regrets are going too small, which does not mean to go large, just when on the fence they suggest going with the larger of two.

A few of the 34/DD... I seriously thought I was a C until I got measured. Basically she looked at the top of the bra and the C/D got a bit of muffin top. My sports bra is a D.

Note I had these done on 10/8/18 so still just two months ago. Second pic is day they were done.

[AlyssaJ]

Thanks for all the replies ladies. This evening I decided to try and give myself some piece of mind so I did rice sizing at home.  It worked.  I filled each side with 325-350cc of rice and it looked like a good, natural size.  I'm realizing part of my concerns have been around cc size but I think I've been comparing apples and oranges. Realizing now how base size, volume and projection are all related, I'm much more comfortable. I also found a few additional sources of information relating cup size to total breast volume that also helped feel more at ease with my doctor's recommendation.

So January 7 I go under the knife.  I have my pre-op appointment in a couple weeks. I do plan to stress to him that when he's comparing sizes in the operating room that I'd like him to err on the side of larger. My fingers are crossed.

[Maid Marion]

Best of luck!

[jill610]

Good luck! Personally, it's gone a LONG way towards feeling better about myself and alleviating dysphoria. Passability has improved as well.

[Harley Quinn]

Good luck! I'm sure things will come out amazing! And with smaller implants, I met a few girls in the 800+ range and "ouch!", you should heal pretty quickly. 🙂

[Colleen_definitely]

The rice test really is the best thing for getting an idea of how big you need to go. I'm glad you're feeling better about it now.

These first few days with mine have been uncomfortable but having nice sized boobs is pretty neato.

[AlyssaJ]

LOL yeah I've had more than one woman tell me it felt like an elephant standing on her chest for the first couple of days.   That's also something that worries me a little though.  I am prone to panic attacks, especially when I feel constriction on my breathing.  Going to be a little interesting those first couple days.  Lots of breathing practice needed.