Anticipated Size Not Achieved After Breast Augmentation

I had breast augmentation surgery last Tuesday. I was a 34 A and wished to be a C or D cup. My consultant advised me that it was achievable, and I would need to go for a 260cc silicone over the pectorals for a C-cup, or 300cc submuscular for a D-cup. I decided to go for the 260 cc in case I would go too large.

However, after the surgery I thought I looked rather small still. I had been professionally measured at 2 different places, and both agree that I am still only a B-cup, albeit a large B-cup. I feel really disappointed with the end result, even before it was confirmed with measurement. My partner maintains that after I've fully recovered and come the summertime, I will be happy with the end result. However, I'm so annoyed that I have had to go through all the surgery, pain, and upheaval (not to mention to be thouasands of pounds out of pocket), supposedly to make me feel so much happier with the way I look.

My partner thinks that I'll be able to put a padded push-up bra to gain the desired effect, but that's missing the point of me deciding to go through breast surgery, right? I'm meeting with a patient advisor and consultant next week. I really am not happy with the smaller than anticipated size, and do not think that I should have to put up with the size and use push-up bras to try to achieve the desired effect I was wishing to attain. How should I approach this with the consultant, and what will I be able to achieve? Would I be able to have the procedure repeated to, so I can achieve my desired full C-cup?

Doctor Answers 11

Commmunication with your plastic surgeon is essential

Even though you are distraught and disappointed over your results, revision surgery is an option for you. Exchanging the breast implants for larger ones is not difficult and is associated with a shortened recovery time. It is advisable to wait at least 2-3 months to allow adequate healing and relaxation of the chest wall tissues. I would strongly encourage you to return to your treating plastic surgeon and discuss your concerns with him/her. Communication is essential!

There are many factors that must be considered when determining breast implant size. Admittedly, there is no precise or exact method available for us to use. Factors that must be considered include your wants and needs, body dimensions, vocation, and outside activities and hobbies. In other words, we must always individualize.

The average American woman stands 5’ 4’’ and weighs 140 lbs…you are petite. On average, 95% or more of our patients choose breast implants between 300-450 cc, or the equivalent of 10-15 oz. Keep in mind that a coke can is only 12 oz. It does not take a large volume to give you your desired look!

We always have our patients try on their implants. This is an important yet simple maneuver that is accomplished by taking various sized implants and placing them into your bra. The proper size implant should generate a feeling of comfort and ‘feel’ right!

I hope you find this helpful.

Englewood Plastic Surgeon

Breast size disappointment

Thank you for your question. One of the most common reasons why women have breast augmentation revision surgery is to change size. It is very difficult for a plastic surgeon to commit to a certain bra size as there are wide range of bra sizes and styles out there. It is not uncommon for a woman to have different bra sizes with different bra stores/brands.
I spend a great deal of time emphasizing during the implant size selection process to try on different external sizers to narrow down the look and size they like rather than try to pick the size based on projected bra size.
At this point, if it has been several months since your surgery and you don't feel your breasts are changing much, then you can consider upsizing the implants. I would visit with your plastic surgeon so they can guide you further.

Anticipated Size Not Achieved After Breast Augmentation

The size of the implants are based on a combination of a patient's goals and objectives and her anatomy. In order to provide a natural looking augmentation, the surgeon needs to evaluate many factors including soft tissue coverage, skin laxity, chest wall width, breast imprint width, the shape of the breasts and relative level of constriction to ensure that the breast implants are appropriate for to your body. 

Understand if there was a misunderstanding by the office of your goals and objectives. If the consultant indicates that your goals and objectives were clear, then ask the consultant if there was a failure of communication between the consultant and the surgeon. The surgeon may have determined that there was a medical reason to opt for smaller reasons which the consultant did not understand.

After you allow your body to heal which may take 6 months, then you can opt for a revision.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 27 reviews

Unhappy cup size after breast augmentation

If you are unhappy with the final size of your implants, you certainly should discuss this with your surgeon. Perhaps you can be revised with larger implants.

Steven Wallach, MD
New York Plastic Surgeon
4.0 out of 5 stars 22 reviews

Breast implants a little too small better than a little too big.


OK.  You are not happy with your size after breast augmentation.  Wait six months.  You may change your mind.  If not, it is pretty easy to replace with larger breast implants.

I wrote an article for RealSelf about how to pick breast implants. You can see it on my profile.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

It sounds like you and your doctor didn't communicate

As the other excellent answers have already emphasized, breast augmentation is not done with the goal being to reach a certain "cup size." This is a formula for unhappiness because there is no true standardization for cup size in the clothing industry and all patient's bodies are different.

The proper way to work out what implants will be best for you is to accurately measure your body for the best implant dimensions and then determine the "look" you want based on the profile of the implant chosen. This way, you will be getting the best implant for your body and your desires.

All of the issues you bring up should have been dealt with before surgery so you wouldn't be in the predicament you are now. You may well adjust to the implants you have but you will never be quite as happy as one would like you to be.

Wait 3 months for implants to drop

The bottom line is that you need to be happy with your breasts after the expense and discomfort of breast augmentation surgery, and you should not have to go to the trouble of push up bras to look the way you want to look.

It is true that you will look larger and fuller after 3 months when the implants drop and more fully distend the breast. So wait 3 months before deciding.

Generally, people who have "A cup" breasts and want a full C cup breast usually require at least a 350-375 cc implant and at least 400-450 cc is required to get to a D cup.

Express your concerns to your surgeon, but give him/her the benefit of the doubt and wait 3 months.

Did you express any concern about 'not wanting to be too large" to your surgeon before surgery? Most plastic surgeons tend to err on the large size. in my experience patients who end up feeling too small after breast augmentation have tended to influence me to go too small because they were fearful of being too large.

If this is the case then you share responsibilty for the result. I am sure your doctor wants you to be happy, and will work with you to place larger implants if you are not happy at 3 months. However, the expense of implants, OR, and anesthesia are considerable and hopefully you can work out an equitable financial arrangement with your doctor if replacement becomes necessary.

Many flaws in the process...

First of all, achieving a particular cup size, while often expressed by patients and touted by "consultants", is not an accurate measure of the goal of augmentation because bra cup sizes is so variable. You should mainly go for a certain look or proportion and use cup size as only a rough gauge.Thus, someone who asks to go from A to B would be somewhat modest in expectations while someone who looks to go from A to D desires a rather dramatic change.

Second, cup size from augmentation is not related to implants size. Rather, it is related to a combination of factors include size and shape of the native breast as well as the chest itself, the style and dimension of the implants, and the technique of the procedure. For example, a 260 cc implant does not automatically translate in a cup size increase. In some patients it will in others, it won't.

Thirdly, and perhaps more importantly, your surgery, the choices, the techniques, and the results should be discussed with your surgeon performing the procedure not a nurse, beauty, business, or surgical consultant. Any patient who does not speak to the surgeon because a consultant is performing these tasks should walk out the office into one where there is a face-to-face discussion of your goals with the surgeon.

Finally, I would wait to render final judgement since a few things can happen. The tissues need to accommodate to the implant and so a result that looks small and compact can expand and look more natural and fuller as the tissues stretch. On the other hand, the implants can undergo capsular contracture in which case the result can look smaller. There is also an adjustment period where patients will relate to their breasts in various ways. As they integrate more into general surroundings and society, their reactions to their implants can change depending on their social interactions. We tell patients to go through surgery for themselves, but it is hard for them not to be affected by what others say. Implants that felt too small can become perfect. Implants that felt perfect can become too small or too large. Wait for a number of months for the dust to settle.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 10 reviews

Be aware of long term changes after breast augmentation

This is a highly personal decision that requires that you relay your desires to your plastic surgeon (or the patient advisor/consultant)so that they may help make suggestions for a breast implant size that will best fit your needs.

However, I have had some insight from taking over a practice that has been around for well over 40 years. THERE IS NO CORRECT BREAST SIZE FOR ALL SEASONS! Remember that as you age, a variety of factors will affect the size and shape of your breasts. This means what works for you now may not work for you in the future. This includes: Aging, sagging, number of preganancies, nursing/lactation, weight gain/loss, birth control pills, menopause, etc.

So although you may agonize over selecting the "right" breast implant size, please realize that this may change significantly with time and necessitate additional surgery at a later date. For example, I have treated two patients with conservatively sized breast implants (275cc) placed in their 30's who then both requested downsizing because they became self conscious when they became grandmothers and their natural breasts had become larger through menopause and the associated weight gain.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 60 reviews

Cup size not accurate

Cup size - even when measured - is inaccurate and depends on the manufacturer and designer as well as how you like your bras to fit. Almost everyone can fit into a size larger or smaller just by simply switching brands, etc. Breast implants are not meant to equate a cup size. You should try to achieve a proportionate appearance taking into account your chest diameter, tissue coverage, height, weight and personal desire for size. If you discussed only cup size with this "consultant", then the process for selecting your implant size may have been misdirected from the start. Have you met with your surgeon to discuss your concerns? Did you meet with the surgeon prior to surgery to discuss your implant size? Did you have measurements taken of your chest prior to surgery or was the discussion only about cup size? Cup size should be respected as that is what women relate to. However, it should clearly be discussed that a specific cup size is not achievable and proportionality is more important. Once you have chosen an implant that matches your body, then you can put a sizer implant into a bra that you would like to fit into and see whether or not it fills it out. Also you can put a form fitting shirt over the bra and then see how you like the size. But the most important starting point is your body and chest/breast measurements. If you are unhappy with your size, discuss your options with your sugeon as you have to go at least about 50cc more from where you are now to have a visually noticeable difference. Also review your before and after photos with your surgeon - that alone sometimes puts everything in prespective.

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.