Choosing the right implant size is one of the most important elements of breast augmentation surgery. It is a process involving both the patient and the surgeon.
In my practice, the following steps are taken:
- Patient expresses their desired size - often in terms of "cup" sizes.
- I examine the patient and make breast measurements (breast width, sternum to nipple distance, nipple to inframammary fold distance, etc).
- I then have patients do sizers with various bras. I have a home kit that allows patients do the size trials at the comfort of their home. I want patients to take their time with this process. I encourage patients to try on various clothing (swimwear, intimate wear, sweater, etc) until they find the size they feel most content with.
- And then I reconciliate, i.e. - I determine whether the size chosen by the patient can be placed based on the anatomic measurements and breast tissue/skin compliance.
For the most part, I try to minimize my input for the size determination, as I truly feel this is a personal decision, and ultimately, patients have to feel content with the size chosen. However, if I feel that the size chosen is not compatible or may compromise the outcome (too tight looking, etc), then I will discuss my concerns with the patient to convey the pertinent anatomic considerations.
It is important to remember that an implant in itself is just one component that determines the size outcome. Obviously, it is in addition to the native breast tissue. Also, the very same implant placed in 3 different women of different height, weight, and physique will produce dramatically different size outcomes. This is the reason why I discourage patients from choosing the size based on photos or friends telling them what size will be "perfect" for them. Size has to be placed within the context of the specific patient's body/breast to have true relevance.
Lastly, although, we discuss breast sizes in terms of "cup" sizes, implants come in "cc" filling volumes - i.e. - how many cc's are prefilled (in case of silicone implants) or desired filling (in case of saline implants). So ultimately, most plastic surgeons do not guarantee a certain "cup" size, although unfortunately, it is the only "language" that we have for commmunication. In my practice, I try to focus on the "look" rather than the "cup" size. My home kit is based on the appearance in front of a mirror, while the patient is "blind" to the actual volume. This allows patients to choose the size mostly based on "what they see" and not on "what they think they need."
Ultimately, there are many ways to determine the right size. My method is just one way that works for me and my patients. Be sure to discuss with your surgeon their preferred method, and see if it makes sense to you.
Be actively involved with your size - after all, it's your breast/body, and you have to be happy with it.
