How to Choose the Right Breast Implant Size

Hi Faye,

I'm glad you're concerned about choosing too large of an implant.  Many of my patients need some convincing that overly large implants look unnatural.  There are a vairety of tools that Plastic surgeons and their patients can use to help select with breast implant size:

• Photos. Having patients bring photos of breasts they like and breasts they detest help me determine their goals. Some women desire subtle enhancement and others desire much more dramatic enlargement.
• Measurements. The chest wall diameter, breast width and height are all important factors in selecting an appropriate implant. The breast skin envelope is only so large; selecting an implant that is too large invariably means that implant will sit too high, too low, or too lateral.
• Trial sizing. Although it is inexact, having patients try different implants in a bra in the office is a useful exercise. It gives them a crude idea of breast size and shape in clothing and often helps them verbalize their goals.  
• Conversation. Different implants have vastly different shapes and profiles.  It's important that you understand how this differs in appearance from other types of implants, and that can only conveyed adequately in the preoperative consultation.
• Intraoperative sizing. We will often utilize intraoperative trial implants and always sit the patient up during surgery to ensure that the breasts have a pleasing appearance.

Hope this helps! Best of luck!

Choosing an implant size is a very difficult decision.  Obviously we (both the patient and the doctor) want to choose the "perfect" size - the one that fits all of the desires of the patient.  Most surgeons use some form of dimensional planning to help suggest a range of implants that will "fit".  These systems measure the fixed dimensions of the chest wall, breast size, skin envelope, as well as the elastic properties of the patients skin.  With this information, a reasonable range of implant sizes can be determined, and hopefully this range matches the patent's desires.  If the patient is looking for a resultant breast volume that is significantly larger than those within the predicated range, then the resulting breasts will not look natural and might result in stretch marks.  It is good to discuss your goals with your surgeon, and have a frank discussion regarding the "look" you want to achieve.

Dr.B

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