The actual size of a breast implant, measured in cc's, is really not very descriptive of what a breast augmentation will look like, or what the cup size will be. It is all relative to the size of the breast and the size of the patient preoperatively. A tall, broad-shouldered patient with small A-cup breasts may require 450cc implants to achieve a C-cup breast volume postoperatively, while a shorter patient with medium B-cup breasts may only need a 250cc implant to achieve a C-cup breast volume.
If a natural appearance is the goal, then the way to get the size right is to 'try out' different implant volumes and profiles in the operating room. Once the implant pockets have been created, sterile sizers can be placed in the implant pockets, and the upper half of the O.R. table raised so that the resulting breast appearance can be assessed with the patient in an upright 'sitting' position (chest fully upright) while under anesthesia. These sizers are available not only for each implant size but also for each implant profile: low, moderate and high (in this practice we use high-profile implants only in rare instances). Inflatable sizers are used for saline implant augmentations, and pre-filled gel sizers are used for gel implant augmentations.
For any patient there is obviously a range of implant volumes that would be considered natural-appearing, and a volume at which the upper pole of the breast begins to look very unnatural. While one patient may seek an augmentation that is 'perfectly natural', another may be interested in a result that is more on 'the full side of natural', and many patients do ask that the largest implant volume be selected that does not produce an unnatural fullness in the upper pole. By using breast implant sizers intra-operatively to determine exactly what breast implant profile and volume produces the best breast appearance in the O.R., patients can be provided with the closest possible approximation of their preoperative goals, and can be assured of a natural-appearing result.