November 04, 2026 | Ask Dr. Agullo, Breast, Breast Augmentation
Which implant size should I get, 220 cc or 255 cc? 650 cc or 700 cc? Will a 475 cc implant look too big or fake? Will a 195 cc implant be too small?
How wide is my breast?
Of the more than a thousand patient questions I have answered on RealSelf since 2010, size is by far the most common topic after revision. Patients want to know what implant volume they should get, but almost no one asks the question that actually decides it, which is the second one above.
Below are ten of those questions, paraphrased and de-identified, with my answers, edited somewhat for this page. Of the ten, two are from 2011 and 2013, one from 2018, two from 2023, and five from this year. My position has not moved: your breast width picks the implant, the profile sets the projection at that width, and the cc number comes last.
“After a breast reduction, how do I pick the cc and the profile for an augmentation?”
Answered on RealSelf, May 2026.
CC is your last step, not your first. After reduction the breast base width will dictate the size of implant you can receive. For most people that are 5’8″ 155 lbs breast width will be 12-13.5 cm and thus would receive 300-375 cc implants. Anything larger will cause side splay and possibly stretch marks which can be seen after 2 years.
Breast reduction leaves a smaller skin envelope and space for implant. CC size is important but CC alone does not give you upper pole fullness or cleavage. Cleavage is better with a moderate-plus implant which has a natural slope to it. More projection to the front and thus more cleavage with a high profile implant. For post reduction patients I do dual plane placement of implants to give the cleavage look under the muscle. I use smooth round silicone implants.
I always bring implant sizers to be tried on in a surgical bra in my office in the exam room and also take measurements including pinch and base width with me to consultations. Pictures tell so much more about implants than CC sizes.
“My chest wall is uneven and my breasts sit low. Which cc and profile should I choose?”
Answered on RealSelf, May 2026.
Never mind the cc number she gave you. Your natural chest width is what determines the implant.
Personally, I would avoid teardrop implants. They are textured, and texture has been linked to a rare type of lymphoma.
If you want that look, a round implant like the Motiva Ergonomix, which moves with your body, is the closest thing.
“I am 5 foot 1, 105 pounds and a 32A. How do I choose a size and profile?”
Answered on RealSelf, Jul 2018.
Breast width is the most important consideration when choosing size and profile. Ideally, your implant should be about 1 cm narrower than your breast width. That is the reason the profile goes up as the implant gets bigger: it keeps the implant width down. An implant that is wider than ideal is more likely to cause rippling, a top heavy look, lateral implant displacement, or side boob.
“My breast width is 15.5 cm and I am looking at a 350 to 375 cc high profile. Is that a mismatch?”
Answered on RealSelf, Sep 2011.
Breast width is what determines the right implant for your breast. For the most natural look and the sleekest contour, choose an implant that is within 1.5 to 2.5 cm of your breast width. If your breast width is 15.5 cm, a 350 to 375 cc high profile implant would not fill out your breast, and that gives you an unnatural, “baseball” look.
“I am 4 foot 10 and 100 pounds. What size works on a petite frame?”
Answered on RealSelf, May 2026.
At 4’10” and 100lbs, the diameter of the base of your chest may limit your implant size. On average for the petite patient the base diameter of the chest wall is 11 to 13cm which will typically be 200 to 300cc for a natural looking implant. Don’t sweat the small stuff, as 20 cc is barely more than a soup spoon (a soup spoon is 15 cc).
“220 cc low profile or 255 cc moderate profile: what is the real difference?”
Answered on RealSelf, Nov 2023.
Moderate profile (255 cc) is a choice that may look slightly narrower and project slightly more forward, which gives the breast a more perky look.
Low profile (220 cc) is a choice that may look slightly wider with slightly more fullness in the upper pole of the breast, but would not project forward as much.
I think you’re right that there isn’t a whole lot of difference between these two implants. Keep in mind the implant profile refers to how much the implant will project forward from your chest wall. Moderate profile implants project out slightly more than low profile implants. Volume refers to the amount of salt water (saline) or gel (silicone) that is put into the implant to inflate it. In general, the more volume you have the bigger your breasts will look. Both of these can give you a natural and feminine look on a petite frame without drawing undue attention. I would speak with your plastic surgeon about which implant he/she thinks would look best on you and why. Many plastic surgeons use 3D imaging programs or other types of computer imaging to help patients visualize what different implant sizes and profiles will look like on them. This may be helpful for you as well.
“I am 450 cc now and want 650 or 700. Is 50 cc a big difference?”
Answered on RealSelf, May 2026.
At 5+ years post op your pocket is very stretchy and accommodating, going from 450 to 650/700 will be a noticeable difference in your breast. Going from 650-700 in a stretchy pocket will not make as big a difference (for most people). 50 cc inside a five-plus year stretched pocket reads as a quarter cup to nobody.
Some things to consider with a significant upsize. As your pocket gets larger your skin will get thinner. The larger your pocket, the higher your risk of capsular contracture. If your IMF (the breast fold) is not reset when you go up in size you may bottom out more. If you are on the thinner side you may see rippling. A high pocket will give you more fullness up high with an upsize (some love this, some do not).
Have your surgeon use implant sizers and a bra to determine the best size for you! Also don’t forget to discuss profile as even at the same cc a moderate plus and high profile implant will give you different results (width/projection).
“My implants ruptured. For the replacements, 430 or 490 at the same width?”
Answered on RealSelf, May 2026.
If by “not massive” you mean close to your goal then I would go with the 430 cc. The 490 cc is the one that sails past “not massive” and into done.
Keep in mind that since you have little to no breast tissue to begin with, the 490 cc high profile implant will stick out further off of your chest wall than the 430 cc implant will (they are both 12.5 cm in width). This may give you more of an edge effect and cause your skin to stretch more over time especially in the lower pole.
I would not recommend sizing based on your photos as they are very dark. If you want to visualize what each implant size would look like, I would recommend using your photoshopped photo and showing it to your plastic surgeon. Then use implant sizers/sleeves to see what size would get you closest to your goal photo. If your goal photo is between your current implant size and the 430 cc implant, use a 100 cc sizer/sleeve. If your goal photo is between your current implant size and the 490 cc implant, use a 160 cc sizer/sleeve.
“I am downsizing. Would 195 cc be too small?”
Answered on RealSelf, Dec 2023.
Based on what you have shared with me, it does sound like you may be interested in reducing the size of your breasts by about a cup and a half. Whether or not that is accomplished by choosing the 195 LP or 220 LP implants will be dependent on what you are trying to accomplish, but keep in mind that the difference between the implants is only 25 cc’s (less than two tablespoons, since one tablespoon is 15 cc) and 5 mm in diameter. In order to make sure that the implants don’t migrate too much in their pockets (especially since your pocket is already formed for a larger implant), you may benefit from a pocket reduction procedure, which may involve mesh. Also, a small doughnut lift may be recommended in order to tighten up your breasts and better adapt the breast tissue to the new implant size.
I hope this information will help you in making a decision about what implant sizes you would like to consider. Keep in mind that there are not significant differences in size between the two implants you are considering. I think it will be very helpful for you to discuss this further with your plastic surgeon at the time of your consultation.
“One month out and I feel I went too big. How soon can I have them out?”
Answered on RealSelf, Nov 2013.
It is very unusual for a woman to find her breasts too big after augmentation, and of those who do, most adapt within two to three months and are happy with the result. At one month you are still quite swollen and the implants can ride a little high, and both improve over the coming weeks. I would wait at least three months before deciding on any further procedure.
The short version
| The question | What actually decides it | My usual answer |
|---|---|---|
| What cc should I get | Your breast base width and the skin envelope, measured, not a wish photo | Pick the width first, then the profile, then the cc lands on its own |
| High or moderate profile | How much projection you want at a width that still fits your chest | The profile goes up as the implant gets bigger so the width stays about 1 cm inside your breast |
| 220 vs 255, 650 vs 700 | A few cc, a few millimetres | Nobody sees it; a soup spoon is 15 cc, so size in a bra with sizers, not by number |
| Going a lot bigger | The pocket has to stretch, the tissue thins | Watch capsule, rippling and the fold; reset the fold if needed |
| Going smaller | A pocket built for a bigger implant | Pocket reduction, often mesh, sometimes a small lift |
| “Did I go too big” at one month | Swelling and high implants | Wait three months; most women adapt by then |
Two of the questions people search for most, “what does a breast augmentation cost” and “why can I see ripples,” have their own posts: breast augmentation cost in El Paso and breast implant rippling. The first roundup in this series, on bottoming out, double bubble and waterfall, covers what happens when the width rule is ignored.
Why choose Dr. Agullo
I am certified by the American Board of Plastic Surgery and the American Board of Surgery, completed my plastic surgery fellowship at the Mayo Clinic, and serve as Clinical Associate Professor of Plastic Surgery at Texas Tech University Health Sciences Center. Castle Connolly has listed me as a Top Doctor every year from 2014 through 2026. Breast augmentation is one of the most common operations in my practice, and sizing is done the same way every time: measure the base width, pinch the tissue, try sizers in a surgical bra, and let the cc number come last.
Ready to talk?
Bring your wish photo and your measurements if you have them; I will take my own. Call (915) 590-7900, text 1-866-814-0038, or book online at agulloplasticsurgery.com/appointments. You can also read my answers on RealSelf. #StayBeautiful
Find me at @RealDrWorldWide on Instagram, TikTok, and Snapchat, @Agullo on X, or @AgulloPlasticSurgery on Facebook.
