How accurate are sizers in sizing bra compared to how end result will look? (photo)

The appearance of the breast after augmentation
does not correlate with the appearance of sizers in a bra. The more accurate technique I prefer to use
is based on cup volume changes. If you
are 32 or 34 each 100 cc’s of implant corresponds to 1 cup size change. If you are 36 or 38 each 200 cc’s of implant
corresponds to 1 cup size change. From
this, you can compute the volume required to achieve your desired goal.Best Wishes,Gary Horndeski, M.D.

Every surgeon has a different approach to helping their patients choose the implants that will achieve their goals.  When using a bra and sizers during a consultation, the patient can have an idea of the proportions they will achieve with an augmentation, but the breasts will look different when the implants are inside of you rather than inside a bra.  I find that this is easier to assess with a tight-fitting shirt worn over the sizing bra.  Some surgeons will recommend going "one size up" from the size you liked in the office but I prefer the approach of picking the largest size with which you feel comfortable while sizing.  It is very uncommon for a patient to feel like their implants look larger in their body than they did in the sizing bra.  Best wishes.

In breast augmentation I have chosen to spend time reviewing
photographs with patients to fully understand their expectation of size and
shape.Many times this simply raises
more questions.I will make measurements
and use the implant guides to allow the patient to understand exactly the sizes
that are reasonable for their body type and measurements.

I have done this for 20 years and done every type of sizing gimmick and nothing like this works well. The only method I have found that is reliable is to have the patient show me in a photograph what she wants to look like with the photo being of a female torso from at least the waist up , upright, and relaxed with arms down - not a photo from a website that is clinical and cropped. After all what we are trying to do is to achieve a certain look and most patients know it when they see it.This allows me to see into her mind so to speak and know what it is she is expecting from the surgery. I then take her preperative photo and compare it to how she wants to look ,and combine this information along with her height, weight, and chest wall measurements and that tells me what type of implant and the size. The new breast imaging techniques are getting better but still are not there yet as the image looks too perfect and I think of it as a sales gimmick.

Although useful as rough guidelines and as communication tools, all the modalities currently used to predict what breast implant size/profile will best achieve a patient's goals with breast augmentation are not very accurate, in my opinion. The use of the rice test, sizers placed beneath a patient's bra, goal pictures, computer imaging technology… are all useful, but not necessarily as accurate as one would hope.
In my opinion, nothing will replace careful verbal preoperative communication with your plastic surgeon, preferably in front of a full-length mirror along with the use of as many "communication" tools” listed above.
In my practice, I use all of the above modalities and then use intraoperative temporary sizers to help determine the best breast implant size/profile to achieve a patient's specific goals as closely as possible. For this reason, I think it is helpful to have the entire range of breast implant  sizes/profiles available in the upper room.
Achieving realistic expectations prior to proceeding to the operating room is also an important part of the preoperative communication process. Patients should be aware that the results of their breast augmentation will not necessarily match exactly what they are visualizing with anyone of the above-mentioned communication tools.
Given your questions and concerns, and given that your surgery is coming up soon, I would suggest that you schedule additional time to spend with your plastic surgeon. This additional time spent will be helpful in the communication process and in alleviating some of your anxiety.
Best wishes; hopefully you will be very pleased with the outcome of the planned procedure.

Sizing for breast augmentation is more of an art than a science.  The first task is getting an idea of how large you are and how large you want to be.  After that, to get an idea of the volume, a sizing system like the one you described is helpful.  Once a range is established, I tend to stick to the higher part of the range.  Finally, by a combination of photographs and demonstrating "shape", the right type of implant can be selected.  I have been hesitant to use a 3D imaging system as this often leads to a patient expectation that may not be realistic and may end in disappointment.

I find sizers to be a useful part of an evaluation for breast enlargement surgery. But this is not an exact science. Provided that patient chooses a size that is appropriate for her anatomy, I will usually choose an implant about 10% larger to achieve that look. For silicone that is usually the next size up. Rather than predicting a cup size (which have no uniform standards) I would say that with slightly larger implants in you will look about the size that you appear to be with the current sizers. All the best. 

Dear nervousmama,I think sizers can be helpful in the office.  I tend to estimate about a 5% decrease from sizer to final size so sometimes a small step up to the final implant can help. All the best,Remus Repta , MD

Thank you for your question and photographs.  Breast implant sizing systems are helpful to give you a general idea of the fullness after breast augmentation, however because they're placed on top of your own breast and not beneath as will be the case after surgery, they are really only a very rough approximation of how you will look after surgery.I agree with your feeling that 420 and 450 cc implants are very large for your frame and size.In my experience a patient with your current breast appearance and body shape Implants in the 250-300 cc range will give you a full B cup  and 325-350 cc will give you a full C.  I certainly would avoid implants and the 400 range.

There is a lot that goes into choosing the best implants for you and this needs to be carefully done with the surgeon and the patient working together. The patient needs to convey the "look" they want to achieve, especially in photographic examples rather than in words. The doctor then needs to assess your starting point and see if the goals are achievable and with what implant profile and base diameter. Sizing bras can then be used to confirm the choice but the implant used in the bra needs to be about 10% smaller that the real one used because you lose about 10% going under the muscle which is the better place for the implants to be positioned.