Good communication between the patient and plastic surgeon is the key to choosing the best size implant for each individual. The surgeon should be willing to work on this for while during the consultation. I allow patients to return for a second shorter consult at no charge if they are concerned about their choice of size.
Steps:
1. I look at how large the patient is now, how large she was during pregnancy and breast feeding if applicable, whether she has lost volume and what her goal is for her final cup size.
2. I look at the patients height, frame, weight, waist, shoulders, and chest measurements. This helps me understand what range of implants will fit well on this patient and look proportional to her body. Most women want to be larger but proportional.
3. The patient then tries on gel filled implants in a bra and puts on a relatively tight T-shirt to judge how they would look with each size in their range. The also try on high and moderate profile implants. This is a step by step process which takes some time. I ask the patient to say if she feels each size is too big, too small or about right, until we find the one size she likes the best.
Quite often the implant that fits the best by their measurements is the size they naturally like the best. I find women usually know what size looks good on their body and their opinion should be the most important factor in the final decision.
Key points:
1. The final result often looks slightly smaller so often I tell the patient I plan to add 25 or 30 ml to what they have chosen if they consent to this.
2. Many women make the comment, "I wish I had gone a little bigger" at the 6 month postoperative visit, so I usually suggest if its down to two possible choices, take the larger of the two. This is partially unavoidable because it is human nature to get used to your new size and wonder what if... I have had fewer problems with this by suggesting that women chose the largest of the sizes that they liked when trying the implants on.
