Breast Augmentation: Q&A

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Why Don't Doctors Encourage Women to Go Bigger?

Almost everyone I know who has has a BA wishes they went bigger. Why don't more docs just encourage them to do so in the beginning? Are they looking for revisions a year or so down the road? I don't get it. My doc made it sound like 500 ccs were HUGE but in reality I don't think they are.

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20 Doctor Answers | Asked by NoMoreBoobEnvy in Maryland

Doctor Answers (20)
Community Comments (2)

Why Don't Doctors Encourage Women to Go Bigger?

I expend some effort trying to determine what my patients want to achieve in size, and my experience, unlike yours, is that most are content with the chosen size. Overall I find that women who are a bit smaller that they might have wished are still pleased, but that women who are larger than they wished are very unhappy! Most of us lose money or at best break even on revisions, and we have patients displeased at having to ;undergo more surgery--I don't think it would be... more

In The End, Big Implants Aren’t All They’re Cracked Up To Be

For most patients, 500cc implants are big. In fact, for the average sized patient, if considering the biomechanical stress of an implant, a “large” implant probably begins at 350cc - 400cc. But implant size does (need to) vary based upon body habitus. A 260cc implant may give a petite woman a D-cup, but be insignificant for someone who is a muscular 5’10” tall. There is significant morbidity associated with large implants: excessive skin stretching, the occurrence of stretch marks,... more

Why Don't Doctors Encourage Larger Implants?

The short answer is, patients don't WANT to go bigger - initially. We all see this. Women undergo breast augmentation because they are unhappy with their breast size. I have patients try on implants from very small to very large then we work our way to what looks the best. Most patients are happy but a small number think every pair of implants look too big. Even if I tell them the implants will still keep them proportionate they are afraid they are too big... more

You can certainly have large implants, but . . .

Your anatomy is the absolute limiting factor of what can be achieved, not your wishes (or even a surgeon's preferences or biases). The latter is evidenced by the differences in opinion in the answers, and your wishes should be foremost, though of course are subject to the limitations of your anatomy. However, since anatomical limitations are defined differently by each surgeon, this is what makes differences in opinion. This is one of those issues that is not black and white,... more

Bigger implants

I almost never find my patients asking for larger implants after having surgery. I think it is because after I examine them and select an implant I then have them do a baggy test. After the baggy test adjustments of volume are sometimes made.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Determining Breast Implant Size

The real issue is long-term support for the weight of the implant. During surgery the implants are placed into a space created under the breast gland or both the breast gland and pectoralis major muscle of the chest. With the possible exception of "shaped" cohesive gel implants, which have a textured surface, a patients body will not "grow into" the implant. So consideration has to be given the long-term support of the implants, which is provided by the ligamentous tissue in the breast.... more

Why Don't Doctors Encourage Women to Go Bigger...

Usually, the surgeon's main concern is patient satisfaction with the outcome of their surgery. However, this concern has to be combined with safety for the patient as well as what looks natural. Deciding the proper size Breast Implants can be very hard for most patients and sometimes they wait until the last minute to decide. The plastic surgeon will often have a try-on session where different sized implants are placed in a bra to give an idea of what size is desired. ... more

The bigger, the more problems

Bigger is not better. The smaller, the more natural and the bigger you go the more problems you may have, such as sagging, bottoming out etc. it's your body, not mine, so go wild if you like.

Why don't doctors encourage patients to go biogger in their breast implants?

Having a breast augmentation is a big decision for the patient. Many patients come with asking for a specific size of impalnts as regards volume. But when choosing implants you cannot just rely on a particular size. It is important to take many variables into account including chest dimensions, quality of the skin envelope, height and weight as well as patient's occupation and recreational sports. Your plastic surgeon has to guide you in trying to achieve the best result for... more

Breast implant size should be determine with the patient's best interests in mind

When it comes to choosing breast implants, I leave the size up to the patient and I just guide them along in deciding what size is best for them. If you think 500cc is right for you, then you should get 500cc implants! I usually take a lot of time with my patients in determing the best size as this is a very important decision. We take implant samples and place them in the bra to get an idea of how they will look after breast augmentation. In addition, we look at... more

Bigger isn't always better in breast implants

It is possible to choose the right or best breast implant for you. Your body limits how big you can go because you can't use wider implants than your chest width will allow. High profile implants of the right width are the max you can have. So, it is naive to assume that you could always just "go 50 cc's bigger." If the implant was chosen properly, you have the max you can have.

Breast augmentation is about you

Everyone has an opinion about what your breast size should be, even your mother, but the only opinion that counts should be yours. Your surgeon should only make your size what you would like it to be and can be based on you breast and chest frame. If you communicate your preferrence clearly things should go just right the first time.

Why Don't Doctors Encourage Women to Go Bigger?

500cc's on one petite body frame can be very large, but on a larger frame can be swallowed up by the surrounding tissues. I encourage all my patients to spend time during the consultation and pre-op process to "try on" implants so that there is no mis-understandings after surgery.

Implant sizing

I not think any honorable plastic surgeon is going to set you up for a second surgery. The truth is that sizing considerations include the ability of your skin and muscle to stretch, the thinness of the skin cover and risks of implant extrusion. If you have some ptosis, then a large implant can lead to further stretching and an aesthetically unpleasing result.

Implants too small after Breast Augmentation

Sizing breast implants can be very subjective. I remind all patients during their sizing interview that nationally the #1 complaint is "I wish I was bigger." If they are on the fence I will recommend they use the larger size. Ultimately though, I feel it is the patient's decision and not mine. Unless things are way out of proportion I let them choose. There are several national experts who recommend smaller implants for technical reasons, but I am more liberal... more

Implant size

Surgeon's goal should always be making sure the patient is happy in the long run. Sizing of implants are done in many ways. But you are right, in trying sizers for the first time most patient will choose a size that may appear too small to them a year later. It is always best to pick a size that is slightly larger than what feels right. There are exceptions that must be considered.

Encourage Women To Go Bigger

Contrary to what one might think surgeons would rather not have to revise patients. Typically this is done for free or a reduced fee so there is a loss to the surgeon from the financial sense as well as the fact that most patients are not usually thrilled about undergoing a second procedure. Having said that I would consider that a physician's job is not to "convince" the patient that bigger is better, but rather to decipher what is being sought through communication with the patient.... more

500 cc Implants Huge for Breast Augmentation

You will find some plastic surgeons who are very conservative in size recommendations and may prefer to place 250 cc to 350 cc in every patient. I just listen to the patient, determine how much larger they want to be, have them try on sizers, and place the same size implants as the size they select within reason. Kenneth Hughes, MD Los Angeles, CA

Breast Augmentation, Determining Size

A happy patient is the goal of most surgeons. Getting exactly the size the patient wants can be a little tricky. I have my patients do the "rice test" which helps them visualize how they will look. Uncooked rice is placed in a nylon stocking and tied into a knot. A woman can test out the sizes and weights of the various sizes of implants by placing them in her bra with her own breasts.Patients who have used this method have a high satisfaction rate with the implant size they ultimately chose... more

Should Surgeons Encourage Patients to go Bigger with Breast Augmentation?

Thank you for the question. I think that, besides careful selection of plastic surgeon, CAREFUL COMMUNICATION is the most important factor in achieving successful outcomes after breast augmentation surgery. In my practice, part of this communication process, especially for “conservative patients” is to let them know that the most common regret after this operation is “I wish I was bigger”. Having said that, there are patients who are very concerned about... more

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Comments (2)

LuluGA 15 Mar 2013

Mine did! After doing some research here (and looking at probably thousands of before/after pics, lol) I definitely will be going bigger than I originally planned!