A lot of Doctors say that their patients wish they had done bigger for BA. Is this true for people filling in pre baby skin.

I am wanting to fill out the skin in my breast and give some volume. I'm small - petite, size -0 and 34a. Don't want to be noticeable unless in swimsuit - and not really noticeable here either - or from my own point of view. Do ladies with these goals in mind usually wish they had gone bigger too? I want very natural restoration of volume. Right now, thinking 200-225cc.

Doctor Answers 11

Natural Breast Augmentation

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Thank you for your question. In my experience there are certainly women who want a very subtle augmentation however I find that it is very common for most patients to adjust to the size increase quickly and find that they do not seem as large once implanted- no matter the volume. Keep this in mind when selecting your implants however careful communication about your aesthetic goals will allow your Plastic Surgeon to provide you with conservative implant options to try.
All the best

The right size for you

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It is very difficult to determine the best lift you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implants

Breast augmentation

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Every one is different when it comes to augmentation. But yes, if anything the majority of patients that are unhappy with their size want to be larger.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast size

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Size of the implants is the most difficult decision a surgeon and patient make.  It truly is about making sure the patient has realistic expectations.  That being said, all women have days when they look at themselves in a particular outfit or swimsuit and with they had gone bigger or smaller.  In my practice I try to optimize the long term results, you want to be happy with the size 10 years down the road, not just 2 or 3.  Good luck, Jane


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I use photos to communicate post-op desires. The keys are  #1 - The patient knowing what they want  #2 - Being able to communicate that effectively to your surgeon  #3 - The surgeon able to properly choose a dimensionally appropriate implant to create that look on you. With good pre-op communication, size regret is quite uncommon. I would advise you to stop trying to figure out "what size you need". You can find multiple implants from both manufacturers that are the same volume but would look entirely different in you because of how that volume is dimensionally distributed.

Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision

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I appreciate your question. The size of implant best for you  is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.   Silicone will give you a fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion. Anatomic gummy bear implants might be a good choice to give you volume. These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak. During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery. Best of luck! Dr. Schwartz Board Certified Plastic Surgeon Director-Beverly Hills Breast and Body Institute #RealSelf100Surgeon #RealSelfCORESurgeon

Getting a perfect, fuller, natural looking breast after breast feeding

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  • One of the most common reasons I perform breast augmentation surgery is to enhance women's breasts after pregnancy and breast feeding have left them a bit hollowed out.  I love that you are talking about small volume implants.  They can fill your breast volume, giving a youthful, perky result that looks beautiful without looking fake.  The ultimate plastic surgery should leave people marvelling at how amazing you look but never knowing that you had work done.  
  • I have a significant breast surgery practise and see a lot of patients for revision surgery from other offices.  I have never increased the volume of an implant in those patients.  Every single time it has been to remove large implants and to make them smaller. Or to lift a breast that a heavy implant has caused to droop.
  • I have never had to change an implant on my own patients because I spend a lot of time trying to customize the surgery to make sure that we choose the perfect implant.  There are four different steps I use to ensure the best size to meet patients' goals.  My patients themselves are quite involved in coming up with the perfect size.  It takes a bit of time but is worth it to get perfect breasts for the rest of your life.

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
5.0 out of 5 stars 85 reviews

Implant sizing for people filling in pre-baby skin

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Thank you for sharing your question, and congratulations on your decision to pursue a breast augmentation.  I would recommend seeing a series of ASPS board certified plastic surgeons in your area to discuss your goal size and appearance.  With a thorough in-person discussion, viewing of goal photographs, and trying-on of implant sizers you can avoid regret in implant selection.  You can obtain a very natural breast augmentation even in a petite frame as yourself but implant selection is critical.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Avoiding size regret with breast augmentation

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While the most common regret after breast augmentation is wishing to have gone bigger, it contributes to a relatively small percentage of reoperation. Women who are able to express their desires comfortably with their plastic surgeon tend to be more satisfied with the size of their augmented breasts. Choosing a surgeon that listens to your thoughts and goals is crucial to ensure happiness with your surgical results. In addition, allowing your surgeon to guide you with her or his expertise with implant selection is an important factor in achieving success. I augment many women before and after childbirth and using an appropriate sizing system with a thorough assessment of the breast skin envelope has proven to be successful in delivering great patient results. 

Most common regret after breast augmentation surgery…

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Thank you for the question.  It is true that the most common regret after breast augmentation surgery is "I wish I was bigger". Having said that however, with careful preoperative communication, the potential for size concerns (too big or too small) is significantly diminished.  In other words, assuming you have selected your plastic surgeon carefully and communicate your goals carefully, it is most likely that you will be pleased with the outcome of surgery and not experience the most common regret.
 Again, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.

  Generally speaking, the best online advice I can give to ladies who are considering breast augmentation 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. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining 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. For example, I have found that the use of words such as “very natural restoration”  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 him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

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, after the use of temporary intraoperative sizers. I hope this (and the attached link, dedicated to breast augmentation for petite patients) helps. Best wishes for an outcome that you will be very pleased with. 

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.