I'm 5'8" and weigh 145 lbs. I want to be a D-DD. What size should I use?

It is really difficult to answer your question as there is a lot that goes into sizing our patients.  We perform measurement, evaluate the skin envelope elasticity, look at photos, look at what the patient came up with the rice test, look at diagrams and finally use the Allergan/Mentor sizing system to size the patient in the office.  We obviously listen and discuss exactly what the patient wants and doesnt want so that we can deliver the expected results.Your breast path to determine what size would work and how big you can be would be to seek out a board certified plastic surgeon to discuss your options.  Make certain the surgeon you choose has great deal of experience in breast implant surgeries.Hope that helps.

Hello and thank you for the question. Photos would be useful. Given your significant weight loss, you might need a breast lift with your implants, depending on the degree of your breast ptosis. An in-person consultation is needed to give you a more specific advice. Many factors including patient's desired breast size, skin envelope (both quality and quantity) and breast width diameter among others are important in selecting the implant size. As a rule of thumb, there is approximately one cup size increase for every 120-150 cc implant volume. In a typical consultation, you try a variety of in-bra sizers and in combination with several other measurements that your surgeon will do, the final implant volume is selected. Use of 'goal pictures' is  also an effective way to communicate your goals with your plastic surgeon. My best advice is that you communicate your goals and aesthetic ideals with your surgeon as clearly as possible and trust your surgeon's skills and abilities to deliver what you are looking for.
Best wishes and good luck,

Pejman Aflaki, M.D.

Johns Hopkins-trained double board-certified plastic surgeon

Thank you for your question.  Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend seeing additional ASPS board certified plastic surgeons to ensure that the implants you decide upon are the right ones to meet your expectations.  It sounds as if it may be wise for you to "try on" several of the implants so that you can have a better visual representation as to what they would look like.  Best wishes! 

Unfortunately, you have not provided photographs.  Since you have lost 145 lbs, you more than likely have a large skin envelope, will not be able to fill out the skin envelope completely with implants alone and would benefit from a lift.  It is possible that you would be a candidate for both simultaneously but that would be determined through your appearance.  Photographs are required for further evaluation.Best Wishes,Gary Horndeski, M.D.

There is no relationship between implant volume and cup size, so to avoid confusion and disappointment, you should look to another method in your surgical planning. In office sizing using purpose build sizers is the most effective way of determining implant volume needs. 

Great question!  It is difficult to talk about breast sizing in a forum like this because it really all depends on your chest measurements, since we don't know that sizing cannot be provided.  The most important factor is to make sure that the implant fits your body, otherwise it will look awkward.  However, your situation may not be as easy as just placing implants.  Understand that volume and skin are two separate issues, you cannot just place a huge implant to fill the extra skin - in fact it will be worse, you will just have very large and very droopy breasts.  Loosing 145 lbs I would imagine that you have significant excess skin which would necessitate a full breast lift.  Therefore, you most likely would need a breast augmentation with a breast lift.  Again, without photos and a physical examination, proper recommendations cannot be provided.Best of luck and hope this information helps!
- Dr. Roger Tsai  @DrRogerTsai
Board Certified Plastic Surgeon

Tall women with larger frames and broader chest,
shoulders, and hips can often handle larger implants that would make
smaller women's chests look overcrowded and heavier.  Remember that
there is no standardization of cup sizes between sizes used by bra
manufacturers. An ABPS board certified plastic surgeon will be able to
guide you to the correct size implant for your measurements and
desires.  Measurements of the chest wall and breast imprint width as
well as knowledge of all breast implant sizes and profiles should make
this process easy. If you want more volume, the implant profile can be
shifted from a moderate profile implant to high profile implant. 
None of the modalities to approximate final results from breast
implants are 100% accurate; they merely facilitate the patient and the
board certified PS concurring on the size and type of breast implant
which will come the closest to reaching the patient's goal. My patients
prefer to try on sizers under garments they typically wear to determine
if they fit as expected and help allay some of their trepidation
associated with this decision. When you consult again in office with
your PS, ask to try on a profile bra with silicone moderate and HP
sizers your PS recommends under garments you typically wear so that you
have the best idea of whether the garments fit as desired with the
implant selected.  I would recommend that you go with the size
that boosts your self-esteem, and fits your anatomy. Choosing an implant
based on an aesthetic goal that exceeds your anatomic capacity may lead
to complications and possibly revision.

With the amount of weight loss you had, I would guess you need a lift and implants possibly. Without photos it’s impossible to know.

Dear Charming1831,
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

Thank you for question. Without photos, breast measurements and a physical exam or is impossible to give you a great answer. For your height, I think in general that would be a good size. This said you need to find a board certified Plastic surgeon who is a member of ASAPS to examine you and take breast measurements. A Vectra 3D imaging system would assist in you seeing different implant sizes on your 3D image. This way you can discuss your goals with your surgeon and he/she can let you know who those goals can be achieved. Best wishes.