The best cosmetic result in any particular breastaugmentation patient depends on a variety of factors, including: Yourindividual anatomy, realistic expectations, a thorough discussion with theplastic surgeon about the options, and an understanding of the pros and cons ofany particular implant choice. Proper sizing is not just about the number ofcc’s. The thickness of your tissue, breast dimensions which include the width,height, and projection, as well as chest wall width all need to be consideredwhen choosing an implant. Trying on implant “sizers” of various shapes andvolumes while wearing a tight t-shirt, bra, or bathing sit at a preoperativevisit will help you and your surgeon choose the optimal implant.There are no manufacturers' standards for cup sizing in the bra industry. Thecups of a 32 D and a 38 D are significantly different. Cup size varies frommanufacturer to manufacturer and even within styles from any particularmanufacturer.Keep in mind that following the advice from a surgeon on this or any otherwebsite who proposes to tell you exactly what to do without examining you,physically feeling the tissue, assessing your desired outcome, taking a fullmedical history, and discussing the pros and cons of each operative procedurewould not be in your best interest. I would suggest you find a plastic surgeoncertified by the American Board of Plastic Surgery and ideally a member of theAmerican Society for Aesthetic Plastic Surgery (ASAPS) that you trust and arecomfortable with. You should discuss your concerns with that surgeon in person.Robert Singer, MD FACSLa Jolla, California
The limiting factors for implant size are (1) your skin envelope and (2) your chest width. For example, if you have loose skin (usually the result of weight loss, pregnancy and/or breast feeding) you can generally accept a larger implant. Similarly, if you have a broad (wide) chest (breast) you can tolerate a larger implant.Conversely, if you have *not* had children and you have very little breast skin, you will be limited to a smaller breast implant. In some cases, a tissue expander can be used to temporarily stretch the skin to facilitate a larger breast implant; this technique is used for breast reconstruction and in certain augmentation cases (e.g. tuberous breasts), but this would be rare.I would recommend finding a plastic surgeon who is comfortable with placing the largest implant you could tolerate based on your measurements. If this is not big enough for you once you have fully recovered (at 3+ months) you could then have them exchanged for larger implants now that your skin will have stretched sufficiently.