I am really nervous about my Breast augmentation on July 17. I am a 32A and I only want to be a B cup. I am so scared that he will make me bigger than what I want. Is there any way other than bringing in all my pictures, and telling him I only want a little bigger? Thank you.
Assurance for Conservative Breast Augmentation Results?
Doctor Answers (14)
Conservative breast augmentation
You are right to be worried about the eventual size of your breasts. The trend in our practice is toward more conservative sizes. Women are now savvy to the damage that large breast implants can do to the muscle, the skin, sensation, requirements for further surgery, rippling, visibility of implants etc.
You may want to discuss in detail the intended size of the breast implant, and specify that size with your doctor prior to the surgery. Usually the surgeon will have samples of implants for you to try, so you know exactly the size you are getting. The consent should read "240 cc smooth silicone moderate profile implant" or the like if you really want to be specific, or a range such as "240 to 270 cc". If you don't narrow down your size wishes and specifiy them to your doctor, how can you be sure you get what you want? Do you want to wake up the completely wrong size just because you had somebody "use their best judgment?" Breast size is very subjective.
Also, it is sometimes a mistake to focus on a specific bra size, since these vary so much from manufacturer to manufacturer.
Most board certified plastic surgeons are well familiar with such size requests and specific wishes and take their patients' needs very seriously.
Being involved in the decision
I don't often have my patients bring pictures. What I do is allow them to place the implants to be used in a sports bra, pull on a t-shirt, and look in the mirror. I encourage them to bring a friend they trust or their spouse and the only promise I can make is that you will not be bigger than what you see. I've done it this way for the past 12 years and wouldn't do it any other way. I on rare occasion have a patient come back at 6 or 12 months and say they wish they were "a little" bigger but it is rare someone feels too large. Talk with your plastic surgeon.
Use sizers or breast implant sizer to help in selecting proper size
I would suggest you "preview" your implant by using a breast implant sizer kit or by using the rice test.
By using sizers, you will have a better impression of the final result.
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Breast implant size
I spend a lot of time with patients going over the size that they want. It is critical to figure out what the patient desires. After doing an accurate assessment and reviewing volumes and types of implants I have the patient go home and see if the volume matches up with what she requested. A "baggy test" with water or rice is a good way to confirm the patients desire.
I like the rice test for breast implant sizing
I think a great way for patients to get an idea of what they would want in terms of size of breast implant is to use the rice test.
Take a ziplock type bag and find a medicine cup like the ones you get with Children's Motrin. The medicine cup is one ounce or 30cc's. Breast implant size is measured in cc's. Fill the bag with rice and remember how many medicine cup-fulls were used. For example, ten cup-fulls is 10 x 30cc's = 300cc's.
Mold the bag around your breast and put on your bra. Wear a snug fitting shirt and then look at yourself to see if you like what you see. You can feel the basic size and have an idea of what size of implant would work for you.
Discuss this with your surgeon to help you make the optimal choice. I always tell my patients to pick the bigger of two sizes if they are down to two choices. I have never had to go back and put smaller implants in, but I have had to go back and put bigger implants in for some of my patients.
Certainly be secure with your discussion with your surgeons, but also look at the rationale for whatever is being done. You both have to understand what "small" and what "a little bit bigger" is.
Bring in a padded bra that produces the result you want. Your surgeon can do some measurements on it.
Find out what the best, most natural fit is for your particular breast. First measure the width of your breast. The most natural implant will be no larger than the diameter of your native breast width. Then use the lowest profile model in a particular manufacturer's catelogue. You can gauge the increase this will give you. Although these dimensions will give you the correct implant, you can double check with the resulting volume. Generally, you should be in the low to mid, 200 ccs. range.
Photos can give you and your surgeon a sense of what visual effect you are looking for. Look at the proportional, the flow of the breast relative to the lateral chest, the amount of cleave, the fullness or lack of fullness on top, the roundness, etc. You cannot however translate another patients implants directly into what you will need. it is the visual effect you are after.
It sounds as though you may not trust your surgeon...
It is very important that you feel comfortable with your surgeon. You need to make sure they are listening to you and understand your concerns and desires. I typically have 2-3 visits with my patients prior to doing any cosmetic procedure. It is vitally important that your surgeon knows you want a small increase. You should also realize that when patients are unhappy after breast augmentation, it is usually because they wish they had gone larger. Maybe some of that bias is coming into play in your consultation. If you don't feel that you have been "heard," then call the office and make another appointment to make sure they understand your concerns. You have PLENTY of time before your surgery and I'm sure they can see you again. Good luck.
Make sure they are listening to you
As long as your surgeon has shown you photos of conservative results to demonstrate that they know how to do this, and as long as he or she is truly listenting to you, just go ahead with trust and confidence...
Bigger is not always better?
I must first ask why you are fearful of your surgeon making your breasts too large. Was something said or alluded to by the surgeon that concerned you? We usually take painstaking efforts to give our patients what they wish for, even if it's a small enhancement from an A cup to a B cup. That being said, most patients that demand a small enhancement end up wishing they had gone a little bit larger. Your surgeon should respect your wishes and goals and if not, then you should seek out another surgeon. Good luck!
Communication is key
There are some limitations when it comes to breast augmentation. Mainly, as the implants get bigger, the diameter increases while the projection increases slightly. One of the main things is to get the proper diameter to fit each half of the chest/breast. Therefore, in order to size you correctly, the breast size may wind up larger than you want. One way to minimize this is to consider low profile and even silicone implants.
Bring pictures, but also try implant sizers on with a bra in the office to get an idea of what the outcome might be. There are however, no guarantees.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.