What size implants should I choose? I'm 5'4", 140lbs. I'd like somewhat of a natural appearance, mostly to add fullness.

Hi D,It sounds like you are seeing a good surgeon who is using "dimensional analysis" to help you with sizing.  That is great!This is perhaps the hardest decision for
a patient to make, as well as the surgeon. Cup size estimates can be
misleading, but I generally advise patients that they will experience an
increase of approximately one cup size per 200 cc. You can try on implants in
the office by placing them into a special bra.Approximately 50 cc (1-2 oz.) is added to the final volume to account
for flattening of the implant in the partial submuscular pocket. Once you
decide on a size you like, then add on about 25-50 cc, because in real life the
implant will be flattened slightly by your tissues.Multiple measurements need to be taken to fit
an implant to your exact anatomy. Have your surgeon's office show you the
charts of the implant dimensions for the various profiles of silicone and
saline from the manufacturer. Then you and your surgeon can piece
together the puzzle by matching your measurements, with your wishes, versus
your tissue cover and the available implants to arrive at a surgical plan.Keep in mind larger implants tend to have
more problems over the years.Since
silicone implants wrinkle less than saline implants, they might be your best
bet.You can also approximate this at
home by measuring out an equivalent amount of rice placed into a cutoff foot of
old panty-hose, and put this in your bra.Wear this around the house for a while, and see what you think.Implant size must square with assessments of
tissue cover, breast diameter, and chest wall width.
Multiple measurements of your chest wall are taken (seven in total). Implant size selection has been an issue of
much discussion. Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape. A photo album of patient pictures is maintained to assist them.
These photos ultimately help in determining where the implants will be placed,
since they can be shifted inside (to provide more cleavage), to the outside, up
or superiorly, and down or inferiorly during surgery. In determining the final
size selection, I always place the highest priority on the preoperative
measurements and potential tissue cover. Then, the patient’s verbal requests
are factored into the analysis.Our
average size over the last 6,000 implants was 350. Be sure to see only a board certified
plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a
member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a
member of ASPS (The American Society of Plastic Surgeons). Also, ask if they
have an established, high volume breast augmentation practice, performing
several hundred breast augmentations each year. Ask to see their before and
after photos if you didn’t see any on their website. If they are
experienced, they should have several 100 breast implant patients for you to
view. I would also recommend that your doctor offer you the chance to
talk to past patients who would be happy to discuss their experience with
you. You need to feel comfortable, so make sure the environment is safe
as in an accredited surgery center. Also, ask a prospective surgeon if he or
she has ever published journal articles in professional peer-reviewed journals,
which they can provide you.All the
best, “Dr. Joe”

Hi and thanks for your question. There are numerous ways to size a patient for appropriate shaped and volume implants so as to achieve a natural appearance with increased breast fullness and projection. I am a strict advocate of dimensional planning, primarily relying on the base width and height of the native breast. Once the width and height of the appropriate implant has been chosen, it is a matter of sizing to decide upon your ideal breast/ implant projection. I prefer to use customised gel sizers under a tight T shirt to help with this decision. Once you have this final dimension you would have automatically selected a narrow range of implant volumes designed to suit your specific chest dimensions and give you the shape you want. In your particular circumstance there are numerous other volumes possible between 320 and 440cc to choose from. It is a matter of altering the profile slightly and/ or considering a different implant manufacturer. Your specialist Plastic Surgeon can expertly guide you through this process. You'll be in good hands. 

Hello! Thank you for your question. In general, implant size does not correlate with bra cup size. The cup size itself will vary from manufacturer to manufacturer as well as who is doing the actual measurements. Thus, cup size is never a reliable indicator for your breast size. I typically encourage my patients not to communicate her desires in cup size but more on the actual look and appearance. Good communication between you and your surgeon of your expectations is warranted - choosing your surgeon wisely is the first step. Discussion of your wishes and having an honest and open dialog of your procedure is mandatory (e.g, implant type, incision, placement, lift, etc). I have found that photographs brought by the patient is helpful to get a visualization of the appearance you wish for in terms of size, shape, fullness, etc. In addition, your surgeon's pre and postoperative photographs should demonstrate a realistic goal for you. Once this has been accomplished, allow your surgeon to utilize his/her best medical judgment during the procedure to finesse the best possible result for you after preoperative biodimensional planning and fitting the right implant for your breast width. Hope me that this helps! Best wishes for a wonderful result!