Surgeon is going to determine breast implant size - is that normal?

The surgeon should have a solid pick for implant size and not leave it to an assistant or decide at the time of surgery. That's how patients become unhappy and start blaming the surgeon later. Your surgeon should help you choose a size.

Every surgeon has a different process to select implant size for breast augmentation, including taking specific measurements, 3D imaging simulations, trying on "sizers" to simulate a specific implant size, and more. It is not uncommon for this to be done with a medical assistant, usually with some input from your surgeon, taking into account the characteristics of your breast, and your desired outcome. It is always best to communicate with your surgeon to make sure you are both on the same page. If you still aren't comfortable after that, then a different surgeon may be a better fit for you.

Hello, thank you for your question. Finding the perfect size can be indecisive. Finding the right size for you is a combination of your wish pics and your chest wall measurements. So we typically use the measurement of you your chest wall to get a range of what sizes will look on your frame. Then depending on what profile you like high or moderate profile. You should definitely try sizes and ultimately the surgeon can decide based on what you like can choose the best implant size and profile that will fit you. The final decision is yours but its good to work with your surgeon to make that decision Feel free to check out our website to learn about sizing.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Great question! In some practices, the surgeon picks the size during the surgery. In my practice, I like for my patience to pick the size so that they know what the outcome is going to be. I let my patients try the different sized implants in my office and then they can see what they are going to look like. If one of my patients chooses a size that I think it’s going to be too big or too small, then we can have a discussion about it before the surgery so that I can explain the implications of that choice. If you aren’t comfortable letting your surgeon choose your size, and ultimately the outcome that you will live with, then you can get a second consultation. Hope that helps. Best of luck!

Since only you and your surgeon know what transpired during your consultation it is difficult to comment specifically as to how things are done in your surgeon's practice, but if you have concerns or reservations you should definitely discuss those concerns with your plastic surgeon and his staff. In our own office I let my nurse help the patient determine which volume most speaks to her with special custom designed sizers (250 cc versus 350 cc) but it is I who will make the final decision with regard to specific implants since you as the patient do not have the information with which to make a good decision about which implant would serve you best. I encourage my patients to share images of women's breasts that they hope to be able to achieve (their so-called "ideal" or favorite), and based on my assessment, measurements, etc. I determine which implant is most likely going to achieve the desired expressed outcome. Best of luck to you.

Dear Tasteful114079,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Breast implant selection is a complex process and should entail a discussion between you and your surgeon. Your measurements should be taken during a meeting with your surgeon and together you should decide on implant options based on this information and your surgical goals.

It is customary for a patient to have some idea of the size they want to be, then for the PS to choose to the implant that will match the patient's goals. It is also customary to try on sizers with a nurse or assistant.

For my patients, we both choose the size during the consultation or the preop examination. I want my patients to be happy and not surprised. If you truly don't know what you want, then let your surgeon pick for you. However, if you don't really know what you want, then perhaps you don't really want surgery.