M. Hugh Bailey, MD

Having trained in Chicago and practiced in Toronto and now Southern California, I've realized people's views on what looks natural vary geographically. The average implant size patients want increases as you move to the south or southwest.

Sit down with your surgeon and try different sizers in a flexible 34D bra (jogging bras often work well and will stretch to a DD). Wear a t-shirt over the bra, and see what size looks good to you. Remeber that sizers look a little bigger in your bra than inside you.

If 450 or 500 ccs looks good to you, then discuss the implant options. I generally use Allergan's textured silicone gel implants, which come in 3 profiles - moderate, mid-range and high. For smaller patients with large implants the mid-range often works well, but the choice depends on how wide your breast is, how your own breast tissue is distributed and whether you prefer more or less fullnes of the breast to the outside.

Putting the implant under the muscle will generally give a more natural profile to the upper part of the breast, with less of a sharp edge to the upper border of the breast.

Review examples of patients your surgeon has treated with similiar implants and which he/she thinks look natural. If, after going through these steps, you still wonder whether you and your surgeon are on the same page, it may be time for a second opinion.