What Factors Help a Woman Determine the Right Breast Implant Size?

Does skin elasticity, level of physical fitness, age, weight and other factors need to be considered when choosing a breast implant that my body would have the best long-term results from?

Doctor Answers 15

Factors in Choosing a breast implant size

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The physical characteristics that you mentioned along breast dimensions enter the decision making process for the recommended size along with the patient's objectives, lifestyle, and lifestage. Since different surgeons weigh these factors differently, recommendations can vary. Consult with 3 - 4 experienced and expert board certified plastic surgeons to review your options.

West Palm Beach Plastic Surgeon
4.5 out of 5 stars 56 reviews

Sizing of breast implants

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Factors that need to be considered when selecting a breast implant size include:

  • Size of the chest wall and diameter of the breasts.
  • The tightness or looseness of the breasts.
  • Ditto for the pectoralis muscle.
  • Activity level of the patient.
  • Sports the patient enjoys.
  • Size and height of the patient.
  • Patient desire (within reason).

One thing that should not be considered include the patient's boyfriends imagination.  Also forget about bra size.  Bra sizes are all over the place and it doesn't matter what size the bra is.  All that matters is  the patient has an attractive and healthy breast after augmentation.

Lisa Lynn Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

Breast Implant Size

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It is important to understand that there is not a wide range of implant sizes and profiles that will look natural in each individual patient. Given your height, weight and preoperative breast profile, there really is a limited range of implants sizes and profiles that will produce a full - but natural - breast appearance. So it is important to establish from the beginning whether or not you and the surgeon that you have selected have the same aesthetic vision. One of the best ways to do this is by reviewing the surgeon's 'before and after' photos.

I spend a lot of time with patients discussing their hopes for the outcome of surgery. I am particularly interested in their preoperative bra size and fit, in getting an idea of their ideal postoperative bra cup size, and in estimating their ideal implant size and profile. Postop bra cup size cannot be guaranteed (and can actually be quite variable depending on the brand), but it can be helpful in trying to fully understand the breast profile that each patient is seeking. During the consultation we take breast/chest measurements and look at a number of different implant volumes and profiles.

Much more important than the number of cc's, or the ultimate cup size, is how it all looks from head to toe. To that end we have patient preop photographs available in the OR, including a shoulder-to-knees photo in both frontal and lateral views. The sterile surgical drapes conceal all but the breasts and chest, so it is extremely important to have a reference for how the augmentation procedure will impact a patient's entire figure.

Michael Law, MD
Raleigh-Durham Plastic Surgeon
4.8 out of 5 stars 123 reviews

Breast Implant Size

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As you mentioned in your question, implant size must be commensurate with assessments of tissue cover, breast diameter, and chest wall width.  Implant size selection has been an issue of much discussion in the literature.  This is perhaps the hardest decision for me and the patient to make. Therefore, I use wide variety of methods, but the implant size is always established preoperatively. Patients are advised to bring reference photos demonstrating their ideal size and shape.  A photo album of hundreds of past patient photos is maintained to assist them. My website has over five thousand patient photos. These photos ultimately help in determining where the implants will be placed, since they can be shifted inside (to provide more cleavage), to the outside, up or superiorly, and down or inferiorly during surgery.  In determining the final size selection, the I  always place the highest priority on the preoperative measurements and potential tissue cover.  Then, the patient’s verbal requests are factored into the analysis.  Cup size estimates can be misleading, but I generally advise patients that they will experience an increase of approximately one cup size per 200 cc. 

During consultation, patient photos were taken, transferred instantaneously to the computer with an Eye-Fi card (Eye-Fi, Mountainview, California) printed, and analyzed. Each patient tries on multiple sizers with a bra, under a thin t-shirt. Most preoperative consultations last about two hours.  The profile of the implant - low, medium, or high - is secondary, while the implant diameter vis-à-vis the diameter of the breasts is primary. In this way,  I work backward with each of the patients, beginning with an analysis of each patient’s measurements, such that the profile of the implant was determined secondarily after the size was chosen. Approximately 50 cc (1-2 oz.) is added to the final volume to account for flattening of the implant in the partial submuscular pocket. All the best, "Dr. Joe"

Factors Determining Breast Implant Selection

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How to Choose an Implant Size?
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 tough to answer your question. For example your native 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, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Additional critical decisions will also be made by your plastic surgeon such as: whether your implants will be above or below your pectoralis muscle. These choices are recommended to you based on the look you desire, the amount of sagging you may have, and other deciding factors. I always find it helpful for patients to bring in photos from my or other plastic surgeons’ websites to illustrate what they would like to look like. I bring these photos to the operating room for reference during surgery so that I have the advantage of “seeing through my patient’s eyes” to achieve their wishes.

The Right Breast Implant Size

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The most important factors in determining the appropriate size for a breast implant are the dimensions of your breast, especially the base width of your breast.  Skin elasticity plays some role in that patients with poor elasticity may be more likely to need a breast lift. 

Michael Sundine, MD
Orange County Plastic Surgeon

The factors that are important in selecting the "right" breast implant size!

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The most important thing to understand is that you must accurately convey to your surgeon what your wishes are, and then let your surgeon's training, expertise, experience, and examination of your unique anatomy help him or her choose WITH YOU what implants will best fit your goals AND anatomic possibilities. This is such a common question on this site--search and read as many answers as you can that I and many of my colleagues have written, including my article about this topic on my "About" page.

Some patients WANT to choose their implants, but you have never done this before! But it's your body, your money, and you have to live with the results, so it is equally incorrect, IMHO, to simply let your surgeon decide "for you." It's his or her job to provide the surgical and anatomic and experiential know-how that only medical school, surgery residency, plastic surgical fellowship, and years of experience with thousands of breast augmentation patients can bring to YOUR consultation to help you help your surgeon get as close as possible to the exact result (not just size) you want!

You CAN, unfortunately, research this to death and only confuse yourself, so see one or more experienced ABPS-certified plastic surgeons who have years of experience and do lots of breast augmentations for a physical examination and detailed consultation. The RIGHT decision is a patient-surgeon collaboration. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Breast implant choice

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I thik you hit the nail on the head. All of those things affect the choice of the correct implant for you, and that is why a phsyical exam and discussion are so very important.

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

Breast Implant Sizing

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Of the five parameters you listed in your question, only two matter when it comes to a good long term result: skin elasticity and 'other factors'.  The other factors include: breast base diameter, breast tissue thickness above the nipple, the subcutaneous tissue thickness at the inframammary fold, and the distance from the lower areolar edge to the inframammary crease.  Using these parameters to determine implant size, projection, and pocket type will minimize all complications associated with breast augmentation and maximize the best long term result.

Choosing implants based on patient's height, weight, or desired bra size frequently goes against the choice based on these objective measurements, and puts the patient at increased risk for unsatisfactory outcome.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Determination of the Best Breast Implant

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If only i were so easy as to just write down a few factors.  There are so many things that go into getting the right look and it really takes a formal consultation and exam to answer that question for each patient because the "right' answer actually may change between patients. Find a good experienced board certified plastic surgeon and he will be able to answer your questions.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 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.