Anticipated Size Not Achieved After Breast Augmentation

In my experience, if a woman wears a size 36 AB bra and would like
to be a C cup, which is the average size that women wear and the average size
bra that is sold, she needs a volume of approximately 350 to 390 cc to make
that change. This becomes less if she's wearing a 34 bra, because it has a
smaller strap size and the cups have a smaller diameter. A smaller diameter
implant would then be a volume of approximately 300 to 350 cc. In the same way
if she was more petite, maybe a double zero or size one and wore a 32 AB bra,
then to become a 32C cup she would only require about 250 to 300 cc.

It's not uncommon for patients to express concern about breast size in the immediate post-operative period. Multiple factors make it impossible to assess breast size one week after surgery.Several factors affect the size of the breasts in the immediate post-operative period. These include swelling of the breasts and surrounding tissue, muscle spasm and the healing process itself. These factors interact in a complex manner to create a rapidly evolving situation. It's virtually impossible to make decisions about breast size until the situation has stabilized.In some cases, it may not have been possible to place a larger implant at the time of the original procedure. During surgical procedures, it's not uncommon for surgeons to make compromises to obtain the best possible aesthetic result. In some cases, utilizing larger breast implants can cause conflicts with other aesthetic goals. For instance, having large implants might create an unnatural look, which may not be desired by the patient. It may disrupt harmony, balance and proportion with other surrounding structures.All of these concerns might place limits on implant size. In most cases, after a period of adjustment patients are happy with their breast size. Rarely, secondary procedures are necessary. For these reasons, it's important to maintain close contact with your plastic surgeon.

Thank you for your question. One of the most common reasons why women have breast augmentation revision surgery is to change size. It is very difficult for a plastic surgeon to commit to a certain bra size as there are wide range of bra sizes and styles out there. It is not uncommon for a woman to have different bra sizes with different bra stores/brands.
I spend a great deal of time emphasizing during the implant size selection process to try on different external sizers to narrow down the look and size they like rather than try to pick the size based on projected bra size.
At this point, if it has been several months since your surgery and you don't feel your breasts are changing much, then you can consider upsizing the implants. I would visit with your plastic surgeon so they can guide you further.

This is a highly personal decision that requires that you relay your desires to your plastic surgeon (or the patient advisor/consultant)so that they may help make suggestions for a breast implant size that will best fit your needs.
However, I have had some insight from taking over a practice that has been around for well over 40 years. THERE IS NO CORRECT BREAST SIZE FOR ALL SEASONS! Remember that as you age, a variety of factors will affect the size and shape of your breasts. This means what works for you now may not work for you in the future. This includes: Aging, sagging, number of preganancies, nursing/lactation, weight gain/loss, birth control pills, menopause, etc.
So although you may agonize over selecting the "right" breast implant size, please realize that this may change significantly with time and necessitate additional surgery at a later date. For example, I have treated two patients with conservatively sized breast implants (275cc) placed in their 30's who then both requested downsizing because they became self conscious when they became grandmothers and their natural breasts had become larger through menopause and the associated weight gain.

The size of the implants are based on a combination of a patient's goals
and objectives and her anatomy. In order to provide a natural looking
augmentation, the surgeon needs to evaluate many factors including soft
tissue coverage, skin laxity, chest wall width, breast imprint width,
the shape of the breasts and relative level of constriction to ensure
that the breast implants are appropriate for to your body. Understand if there was a misunderstanding by the office of your goals and objectives. If the consultant indicates that your goals and objectives were clear, then ask the consultant if there was a failure of communication between the consultant and the surgeon. The surgeon may have determined that there was a medical reason to opt for smaller reasons which the consultant did not understand. After you allow your body to heal which may take 6 months, then you can opt for a revision.

If you are unhappy with the final size of your implants, you certainly should discuss this with your surgeon. Perhaps you can be revised with larger implants.

Even though you are distraught and disappointed over your results, revision surgery is an option for you. Exchanging the breast implants for larger ones is not difficult and is associated with a shortened recovery time. It is advisable to wait at least 2-3 months to allow adequate healing and relaxation of the chest wall tissues. I would strongly encourage you to return to your treating plastic surgeon and discuss your concerns with him/her. Communication is essential!
There are many factors that must be considered when determining breast implant size. Admittedly, there is no precise or exact method available for us to use. Factors that must be considered include your wants and needs, body dimensions, vocation, and outside activities and hobbies. In other words, we must always individualize.
The average American woman stands 5’ 4’’ and weighs 140 lbs…you are petite. On average, 95% or more of our patients choose breast implants between 300-450 cc, or the equivalent of 10-15 oz. Keep in mind that a coke can is only 12 oz. It does not take a large volume to give you your desired look!
We always have our patients try on their implants. This is an important yet simple maneuver that is accomplished by taking various sized implants and placing them into your bra. The proper size implant should generate a feeling of comfort and ‘feel’ right!
I hope you find this helpful.

Cup size - even when measured - is inaccurate and depends on the manufacturer and designer as well as how you like your bras to fit. Almost everyone can fit into a size larger or smaller just by simply switching brands, etc. Breast implants are not meant to equate a cup size. You should try to achieve a proportionate appearance taking into account your chest diameter, tissue coverage, height, weight and personal desire for size. If you discussed only cup size with this "consultant", then the process for selecting your implant size may have been misdirected from the start. Have you met with your surgeon to discuss your concerns? Did you meet with the surgeon prior to surgery to discuss your implant size? Did you have measurements taken of your chest prior to surgery or was the discussion only about cup size? Cup size should be respected as that is what women relate to. However, it should clearly be discussed that a specific cup size is not achievable and proportionality is more important. Once you have chosen an implant that matches your body, then you can put a sizer implant into a bra that you would like to fit into and see whether or not it fills it out. Also you can put a form fitting shirt over the bra and then see how you like the size. But the most important starting point is your body and chest/breast measurements. If you are unhappy with your size, discuss your options with your sugeon as you have to go at least about 50cc more from where you are now to have a visually noticeable difference. Also review your before and after photos with your surgeon - that alone sometimes puts everything in prespective.

First of all, achieving a particular cup size, while often expressed by patients and touted by "consultants", is not an accurate measure of the goal of augmentation because bra cup sizes is so variable. You should mainly go for a certain look or proportion and use cup size as only a rough gauge.Thus, someone who asks to go from A to B would be somewhat modest in expectations while someone who looks to go from A to D desires a rather dramatic change.
Second, cup size from augmentation is not related to implants size. Rather, it is related to a combination of factors include size and shape of the native breast as well as the chest itself, the style and dimension of the implants, and the technique of the procedure. For example, a 260 cc implant does not automatically translate in a cup size increase. In some patients it will in others, it won't.
Thirdly, and perhaps more importantly, your surgery, the choices, the techniques, and the results should be discussed with your surgeon performing the procedure not a nurse, beauty, business, or surgical consultant. Any patient who does not speak to the surgeon because a consultant is performing these tasks should walk out the office into one where there is a face-to-face discussion of your goals with the surgeon.
Finally, I would wait to render final judgement since a few things can happen. The tissues need to accommodate to the implant and so a result that looks small and compact can expand and look more natural and fuller as the tissues stretch. On the other hand, the implants can undergo capsular contracture in which case the result can look smaller. There is also an adjustment period where patients will relate to their breasts in various ways. As they integrate more into general surroundings and society, their reactions to their implants can change depending on their social interactions. We tell patients to go through surgery for themselves, but it is hard for them not to be affected by what others say. Implants that felt too small can become perfect. Implants that felt perfect can become too small or too large. Wait for a number of months for the dust to settle.

Hi.
OK.  You are not happy with your size after breast augmentation.  Wait six months.  You may change your mind.  If not, it is pretty easy to replace with larger breast implants.
I wrote an article for RealSelf about how to pick breast implants. You can see it on my profile.