Picking Implant Size after Reduction (photo)

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins").
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Thank you for your inquiry!! Come in the office, try on some implants and see what size fits your goal. A scar revision can be done at the same time of the breast augmentation. We would love to meet with you to discuss your concerns. Schedule a consultation with a Board-Certified Plastic Surgeon to discuss your goals.

Even though your doctor has recommendations, it is best to explain in very certain terms what look you are trying to achieve. Sometimes a second visit to evaluate sizers is a good way to proceed. A lot of the consideration will be the amount of upper pole fullness you want. Good luck with your surgery.

Hello and thank you for your question. Honestly, a formal in-person evaluation would be needed to determine the best treatment- ESPECIALLY in the context of prior breast surgery and potential asymmetry. There are several reasons for this:
1) Bra sizes vary based on the clothing store (for example, Victoria's Secret tends to upsize everyone by a whole cup size)
2) Most women do not wear the proper exact fitting bra size for their bodies
3) The exact volume (in cc) needed to change cup size is different for different body types (e.g. 32A to 32D requires a different implant size than 38A to 38D)
4) Be careful NOT to fall into the trap most women do- they see a certain implant size (e.g. 285 cc) or perhaps their friend had a certain size, and they want or request this or another size based on that. Everyone's body is different- 285 cc implants on your friend might look VERY different than they would on you. Be very careful not to make this mistake, because the goal is to find the right size and shape for YOU- for your particular body and your breasts.

Because of those multiple factors, and because it is KEY to fully evaluate your breasts in person to make a full set of precise measurements to select the proper implant for you (incorporating factors like amount of breast tissue, implant type, base width, projection, etc), answering your question really would need a formal personalized consultation- to say anything before that would simply be guessing, which would be both unfair and unhelpful to you.

Your breasts are such a KEY area of your body and your femininity- therefore, you should ONLY trust an experienced aesthetic plastic surgeon. As such an expert, I have had extensive training and experience with complex aesthetic surgeries under a multiple world-renowned experts in the field. I’d recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with aesthetic plastic surgery procedures) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Dear jf4404,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient.
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Please ask your surgeon if you can try on sizers. These are implants that you can fit into your bra. It is one of the easiest ways to see how you may look after surgery so you can determine whether the recommended size would achieve your goals.

The most accurate way to determine implant size is through the use of sizers worn under an unpadded bra and viewed in the mirror with your top on. This will give you the best recreation of how you'd look with a specific sized implant. If this was what you and your surgeon did, then don't worry. If not and your doc was merely guessing, I'd be concerned too.

At size 32 or 34, each 100 cc of implant corresponds to 1 cup size change. At size 36 or 38, each 200 cc of implant corresponds to 1 cup size change. From this, you can determine the volume required to achieve your desired goal. Another alternative to consider is fat transfers.

Best Wishes,

Gary Horndeski, M.D.

This is a question that 90% of patients undergoing breast augmentation have a problem with. One of the guidelines to consider is that in your body shape/size, one cup size is possibly within 150-175 ml. So, providing that you want to be two cup sizes up range from 275 to 350 would be something to consider. This is best discussed with your surgeon; 30-50 ml is not going to make a big difference. Good luck.

Good question. This is a bit confusing because it sounds like you weren't allowed to participate in your sizing, which to me seems like a huge red flag with how your surgeon's office is run. Patients need to be involved in sizing otherwise it's setting things up for dissatisfaction. In the revision side of my practice one of the most common reasons we are changing implant sizes or removing them altogether is because the surgeon arbitrarily decided what the patient was going to get, leaving them unhappy then putting them in a position to spend more money to get what they should have gotten in the first place.

A proper breast implant sizing session should involve dozens of measurements of your chest then some version of you trying on sizers. Whether it is with physical sizers or 3D imaging you need to be involved in the process so you can get a sense of what you'll look like with the final implants. It sounds like you should get a second and maybe 3rd opinion on this before moving forward with your current surgeon.