Trying to Choose Implant Size. I Trust my Surgeon. Should I Give Him Discretion?

Hubs is out of town so I'm on my own here, Surgeon said post 2 kids I have little sag and no lift recommended (measure 21 from collar to nipple). I have lost a good amount of tissue and he suggested 250-320 cc's. When using the samples the 330 measured the best to keep my hips just slightly larger so not to appear "top heavy." Talking to many friends with augmentation, most say they wish they went larger. Within reason, is okay to chose a size but give the surgeon discretion during the surgery?

Doctor Answers 13

Choosing a breast implant

It is a mutual proces between the surgeon and the patient to choose the right implant for you.  Your part is to carefully demonstrate the "look" you want and the doctor's part is to use your personal starting point, measurements, years of experience and their good judgement to come up with the best implant.  Then use sizers to try to estimate what the result would be like.

Otherwise, if you liked the 330 sizer, go another 50 cc more under the muscle and you will just about get that look.

Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Choosing the right breast implant size

Choosing the ideal implant is the decision that creates the most stress in almost any plastic surgery patient.  This is a decision that should be based on communication between the patient and surgeon.  The surgeon should direct the patient to a range of possible options and then the patient has to make a best guess.  The big issue is that your skin or muscle may make an implant appear bigger or smaller that what you sized, and this is sometimes something you cannot determine ahead of time. Thus,for an ideal outcome most surgeons would want the ability to change your implants at the last minute just in case your body doesn't follow the initial plan.  The best time to make that decision is in the OR and the surgeon cannot wake you up to get your opinion.  Communicate with your doctor and then you need to trust his/her judgment.

Best of luck

Vincent Marin, MD, FACS

San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Give your plastic surgeon final discretion in the breast implant choice

It is important that you and your plastic surgeon have a full discussion regarding your desires for size as well as shape. Even reviewing your likes and dislikes on a variety of photos would be helpful in addition to trying on the implants in the office. Make sure that he/she understands exactly what you want.

Ultimately, I would strongly recommend that you leave the final decision of the most appropriate implant up to your plastic surgeon. Specific numbers (cc's) don't necessarily translate into a specific look - and the appearance is the most important issue. My philosophy is if there is any doubt intra-operatively with regard to size - go with the slightly bigger implant. It is rare that the results will be disappointing!

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 30 reviews

How to choose breast implant size--surgeon's discretion or patient's choice?

Plastic surgeons who do lots of breast surgery have performed hundreds or even thousands of breast enlargements, and have extensive experience in helping their patients choose implant sizes that are compatible with individual anatomy. But what about the patient's wishes?  Every patient has a "perfect size" in her mind's eye, and all the surgeon needs to do is figure out what that size is, and whether or not it will match appropriately with the patient's chest and breast base dimensions, skin and muscle capacity, position of the nipple-areola complex, as well as a host of individual anatomic factors.

Of course, patients often have input from friends who have undergone this operation, have a "great result," and have ____cc implants. "Get those!" she tells you. But you may not even know what proportion of her present breast + implant size is her, and how much is implant. Unless your breasts exactly match your friend's pre-operative breast size (doubtful), you will need different implants added to your own tissue to get similar results.The problem is determining what size is best for you, which can be difficult when you have other "friends" that give "advice" that you will be top-heavy or have a "porn-star look." Compared to whom? Or is she just a bit jealous? I have seen entertainers, models, and everyday women with breasts of all sizes and shapes--some of whom ask me to give them something different: bigger, smaller, higher, or with an improved appearance. What is best for one is definitely not best for all.

Forget what such "friends" say (or at least take these comments with a truckload of salt) , and choose a size that makes you feel good about yourself. If your plastic surgeon disagrees, listen to his or her reasons--your anatomy may not accommodate your wishes. But for MOST women, the size you choose is not only possible, but perfect for you! Remember, you should never do surgery to please someone else, or to try to conform to someone else's opinion.

I start with breast examination, careful measurements (everyone is asymmetrical!), and then ask the patient what her goals are. Based on her anatomy and measurements, I can then determine if her requests can be achieved, based on my training and experience. If not, I tell her, and we try to figure out what CAN work, and how to best get CLOSE to her ideals. I like photographs that the patient finds for the desired "After" result--don't try to match your height, weight, or preoperative breast appearance to the photos, and don't use the stated implant size as a guideline for choosing your implant size. Trying implants on in a bra and stretchy top is helpful also, but realize that your surgeon will need to add 50-100cc to your chosen implant size to give you a look inside your body (under your muscle) that is closest to your chosen appearance in a bra. Show your surgeon how you would like to look, and let him or her use their expertise to get as close to that look as your breast anatomy allows. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 255 reviews

Picking your implant size

Choosing the right implant size is like picking the right dress for you without trying it on.  It's difficult and there is no "right" answer.  Also, keep in mind that small differences (implants that are smaller or bigger by less than 30 cc) are generally not noticeable to anyone.  So, I would first determine, if you are comfortable guessing bigger or smaller.  If bigger, choose the larger implant.

Bivik Shah, MD
Columbus Plastic Surgeon
4.4 out of 5 stars 26 reviews

Trust Yourself When Choosing Implant Size

You know better than friends or even your surgeon which size implant with which you will be happiest.  After trying on different sizes of implants, you should, however, trust your surgeon to make certain that you have chosen implants which fit your breast (breast diameter, etc.).

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Trying to Choose Implant Size. I Trust my Surgeon. Should I Give Him Discretion

It sounds as if you are taking a reasonable approach to the process. However, I would definitely give your input. If you plan on going under the muscle add an addiional !5% to the sizers used in the office to approximate the loss in projection from muscle compression

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Breast implant sizing is important

I tend to choose implants based on a patient's breast dimensions and their desire to look 'natural' or 'augmented' - I typically use smaller implants than a lot of surgeons, but patients tend to be happy with their choices because we have talked a lot about post-op expectations. Anecdotally, I think smaller implants are better for breast tissues over the long term.

Scott C. Sattler, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 65 reviews

Breast implants

Choosing an implant is a very difficult decision, even with 3-D technology.  The final decision is always up to the patient and their plastic surgeon.  I would recommend that if you trust your plastic surgeon, then go ahead and trust his judgment.  He has experience.

Shahin Javaheri, MD
San Francisco Plastic Surgeon
4.4 out of 5 stars 6 reviews

How to pick breast implants.

How to pick breast implant sizes

Article by George J. Beraka, MD
Manhattan Plastic Surgeon1) This is the most common type of question on RealSelf.

2) It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical.

3) Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like.

4) Then your surgeon has to tell you if your chosen look is realistic for your anatomy. The most common mistake is to go too big.

5) I recommend that the surgeon NOT make a final implant choice in advance, because this is just an educated guess.

6) The surgeon should have a large inventory of different size and shape implants available in the operating room.

7) Then the surgeon can put sterile disposable implant SIZERS in your breasts during surgery, to see what a particular implant really looks like inside you. This is how to make the best choice. A sizer costs only $45, and takes all the guess work out.

8) Finally, the sizer is discarded, and the correct breast implants (based on what you want and on your anatomy) are opened from the operating roon inventory, and put in your breasts to complete the operation.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

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.