Thank you for the question. There is no accurate/reliable/predictable correlation between size/profile breast implant utilized and cup size achieved. For example, I do not think that the generalizations of "200 cc equates to 1 cup" hold any validity or are helpful in any specific or practical way. In my practice, I ask patients not to communicate their goals, or evaluate the outcome of the procedure performed, based on cup size references. Generally speaking, patients undergoing the breast augmentation/lifting combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery. Also, patients undergoing the combination breast augmentation/lifting surgery should understand that there are limits as to how large of an outcome can be achieved, given that breast lifting surgery does involve breast skin removal. On the one hand, breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope. These 2 forces are counteracting each other. In my practice, "tailor tacking" is an important part of the mastopexy and mastopexy/augmentation procedure. It involves TEMPORARY closure of the skin (for example with temporary skin staples) to double check the amount of skin that is to be excised during the procedure. This maneuver is done to ensure that enough skin, but not too much, is removed. On the one hand, it is important that enough skin be removed to achieve the aesthetic breast lifting results the patient is looking for; on the other hand, is important not to move too much skin creating tension upon closure and potential wide scars. Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting surgery (regarding breast implant size/profile selection) is:1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. 2. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.Best wishes.
The best cosmetic result in any particular breastaugmentation patient depends on a variety of factors, including: Yourindividual anatomy, desired outcome, realistic expectations, a thoroughdiscussion with the plastic surgeon about the options, and an understanding ofthe pros and cons of any particular implant choice. Proper sizing is not justabout the number of cc’s. The thickness of your tissue, breast dimensions whichinclude the width, height, and projection, as well as chest wall width all needto be considered when choosing an implant. Trying on implant “sizers” ofvarious shapes and volumes while wearing a tight t-shirt, bra, or bathing sitat a preoperative visit will help you and your surgeon choose the optimalimplant.There are no manufacturers' standards for cup sizing in the bra industry. Thecups of a 32 DD -DD+ and a 36 DD-DD+ are significantly different. Cup size varies frommanufacturer to manufacturer and even within styles from any particularmanufacturer. There is also no direct correlation between an implant size orshape and resultant cup size.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 that your plastic surgeonbe certified by the American Board of Plastic Surgery and ideally a member ofthe American Society for Aesthetic Plastic Surgery (ASAPS) that you trust andare comfortable with. You should discuss your concerns with that surgeon inperson.Robert Singer, MD FACSLa Jolla, California