How does a surgeon choose the height of the implant? (Photo)

I am due to get a BA and my surgeon has chosen anatomical under the muscle, full height, moderate projection. 315cc in the left and 270 in the right due to asymmetry. I am hoping for a very natural looking D (I am currently a B in the right and a small B maybe A in the left). I have asked for the natural look, however, I am worried that the full height will result in a fake look, with lots of upper pole fullness. Can anybody advise reasons why a surgeon may opt for the full height?

Doctor Answers 8

How does a surgeon choose the height of the implant?

Selecting the right height of an implant has a lot to do with measurements of the chest and also your overall height and torso length. I tend to select full height implants on pts that have a longer torso. Shaped implants in general do not have a lot of volume in the upper pole so I wouldn't be worry about it being too full. Best of luck. 


Jacksonville Plastic Surgeon
5.0 out of 5 stars 63 reviews

Implant selection

Hello and thank you for your question. You are a great candidate for a breast augmentation.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 77 reviews

Implant size choice is difficult

The most difficult decision in implant surgery is choosing the right implant.  Make sure you have an open conversation with your plastic surgeon, try on sizers, look at hundreds of before and after photographs before you decide which implant is best for you.

Based on the one limited photograph, you have a slight tubular deformity with a high inframammary crease, and a cylindrical shape to your breasts.  I can't tell if the breasts are different sizes from the photograph.  You may want to consider some shaping issues along with the implant insertion.

Also, a rough rule of thumb is a 200 cc implant size for each cup size.  So, if you are an A cup, it will take 200 cc to a B, 400 cc to C, and 600 cc for a D cup.  If you are just looking at 270-315 cc implants and want to increase to a D cup, you might be disappointed with the final result.  I would probably start all over from scratch and re-evaluate your situation.

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 73 reviews

You might also like...

How does a surgeon choose the height of the implant?

Thank you for sharing your question and photograph.  Implant selection is based off of key breast measurements that were taken during your consultation and matched to the particular implant style that best approximates the desired appearance you are interested in obtaining.  Hope this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Full height or not?

Thanks for your question. Your surgeon has likely come to the decision based upon your measurements, but also based on personal style or opinion. Ask your PS about the decision if you are concerned. The manufacturers make sizing sets so you may be able to look at sizers on your frame as well.

I have included sizing faq below as well hope they help.

Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 90 reviews

Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

How does a surgeon choose the height of the implant?

Thank you for the question. There are several steps taken to select a specific size/profile breast implant for a specific patient. The difference between the different profiles of breast implants available have to do with the dimensions (diameter and height) of the implants. For example, the high-profile implant has a greater projection and a smaller diameter compared to the moderate profile implant. The moderate plus profile implant as projection and diameter characteristics that fall between the moderate profile and high profile implants.



 I prefer to have a wide selection of implants (all profiles) available in the operating room. I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.



I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.


Ultimately, 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 “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 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/video, dedicated to breast augmentation surgery concerns) helps. Best wishes.

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

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

#RealSelf100Surgeon

#RealSelfCORESurgeon


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.