Dithering about cup size: Booked in 5 days for a BA w. lift on one side (Photo)

I'm 5'4", 123lbs, 45y.o., w. athletic build, b/fed 3 children, 36A w. strong (read barrel) ribcage. I'm not after large breasts, more to restore fullness (lrg B) & shape. I'm comfortable that the surgeon measured for diameter, but was left in care of his patient admin. for size selection. She recommended low profile, gel, 276cc. however after trying a few, settled on 240cc. I'm worried this is too small. I don't want to waste $11k, but also don't want too big. Any thoughts are appreciated! Thanks!

Doctor Answers 13

Avoiding Death Valley in breast augmentation

Your photo demonstrates a starting point with the potential for a wide gap in the middle (Death Valley) if the chosen implant isn't wide enough. I use moderate classic Mentor gels on about 70% of my patients because these are the folks who don't want a fake look. I'd revisit this with your surgeon in person to be certain before surgery.

Implant Selection

I would recommend another implant sizing session and do this with your surgeon present in the room if they were not previously there.   It is important to show your surgeon the size that achieves your goals, then have your surgeon guide you to the appropriate implant cc size and projection to optimize your shape and size during surgery.

 It is very difficult to accurately discuss implant volume without an exam and detailed measurements.

In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics. There is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor. The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant. It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you during the sizing process. Close intereaction and involvement from your surgeon during this process can help alleviate the anxiety and fears of choosing the right size.

I wish you a safe recovery and fantastic result.

Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 65 reviews


This is always a difficult decision for some. In my opinion, the best thing to do is have a thorough sizing session. I provide my patients with a range of about 3-4 implants that are appropriate for their specific measurements. I then have them try these implants on in a special sizing bra. With this process, my patients have been able to choose their own implants. I have found this to be the best method for implant sizing. Be sure to see a board certified PS in your area. They should be willing to spend the time with you doing this. Best of luck!

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 33 reviews

Second guessing implant size before surgery

IMO, the only person sizing the patient should be the person doing the surgery and that would be the surgeon.  The sizing process is just too important to be left up to an assistant or even a skilled nurse.  Only the surgeon has a good feel for how your particular tissues will respond to any given size or shape of implant.  Volume is just one of many factors that determine the eventual outcome of breast augmentation.  

From your photos, it looks like your chest is really wide and I think the 240 and 276 will not have a sufficient diameter to fill you out.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 57 reviews

Implant volume

Once you have decided on an approximate volume, you can always perform a baggy test with the volume you desire to get a rough idea of how it looks in a bra.  Good luck.

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

Cup Size

First of all, if the Dr. doesn't care enough about the results to speak to you personally about choices, you should be seeing another doctor. This is too big a decision to rely on the assistant. Tell him you want another appt. Low profile below 300cc will probably not satisfy you. I don't know your breast width but just from looking at the photos the width of your implants is probably woefully inadequate. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 18 reviews

Size selection in breast augmentation

You are starting from a great place, and personally I enjoy creating a filled out natural breast.  I suspect a 240 is right on the money, as that will make you a cup and a third or so bigger than you are now.  I suspect a low profile or moderate profile is best for you to again fill out the breast you have.  But, if you are at all uncomfortable, go back to your doctors office and try sizers again.  Take a couple of different tops and just make sure you are comfortable.  If you need to speak with your surgeon again then do it sooner, not the day of surgery.  Remember the difference between a 240 and 275 is about 2 tablespoons, but that may be your tipping point.  As board certified plastic surgeons, we know this is not the same as a new hairstyle, and we appreciate having patients that take it seriously.  More care on this end will make you happier after.  

Melinda Haws, MD
Nashville Plastic Surgeon
5.0 out of 5 stars 34 reviews

Consider different shape and size

You have a fairly wide chest wall and I think a low profile implant will not be a good shape and the size may be small to balance your frame. I would consider a moderate plus shape in the 300 cc range to 325 cc

Munish K. Batra, MD
Del Mar Plastic Surgeon
4.0 out of 5 stars 18 reviews

Dithering about cup size: Booked in 5 days for a BA w. lift on one side

Thank you for the question and pictures. Base on your photographs, you are starting at a great place and should have a very nice outcome with breast augmentation/lifting surgery. In regards to specific size/profile of breast implant, despite good intentions, online consultants will not be able to provide you with  meaningful specific advice.  Careful measurements, dimensional planning, and careful communication will be key.
Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work. Given your concerns, I would suggest that you spend additional time with your plastic surgeon;  ask the same question of him/her regarding the use of ultra-high-profile implants  and the greater projection that results from the use of these breast implants.
2.  Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C cup" etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.  The use of computer imaging may be very helpful during this communication phase.
3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.  The use of temporary intraoperative sizers with the patient in the upright position are very helpful.
 I hope this, and the attached link, helps.

Concerns 5 days before Augmentation

Thank you for your pictures.  If you have concerns about the implant selection I would revisit the size with the plastic surgeon and not the administrator.  As a side note I have rarely used a moderate profile implant for a cosmetic augmentation.

Earl Stephenson, Jr, MD, DDS, FACS

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.