Does the plastic surgeon ultimately let you choose what size of cc even if its not what they recommended?

I think you have brought up an important question.  That is, who makes the final decision regarding the implant size that is chosen?  Every Plastic Surgeon has his or her own philosophy about this, but I will give you my perspective.  I think it is best treated as a group decision between the surgeon and the patient.  In my practice, my cosmetic consultant and I spend a good deal of time talking to the patient during the initial consultation trying to determine exactly what her goals are. Looking at "goal" photos helps us to understand what she is looking for.  I stress to them that a specific size gives each person a different result.  For example a woman who is 100 lbs and 5'0" tall will get a very different result with a 300 cc implant than woman who is 150 lbs and 5'9" tall. For this reason, I don't think that the calculations that you mentioned are very accurate.  During the exam, I take several measurements that help me determine which implant sizes will fit best for that individual. By that I mean which implants will provide a natural result while minimizing the risk of short or long term complications.  In general, women who have had children can accommodate larger implants than women who haven't, because there skin is less tight. We then assist the woman in "trying on" sizers with a bra to see what look they like.  Assuming a woman wants an implant size that is larger than what I recommend, I will review the increased risks associated with their choice.  This usually includes an increased risk of numbness or pain as well as an increased risk that the implants will move out of the ideal position over time.  In general, I will allow them some leeway, however if I feel that an implant is so large that it puts her at increased risks of a bad outcome, I will not agree to using it.  It is best to have an in person consultation with an experienced, board certified plastic surgeon in your area.  Best of luck.  

Thank you for the question. There is no accurate correlation between size of breast implant and cup sizes achieved. In other words, I do not think that the generalizations that you mention in your post are accurate enough  to be helpful for specific patients' care.

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're 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. I have found that the use of words such as  “natural” or "full 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, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size.

 The use of computer imaging technology may also be very helpful during this communication process.

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. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.

I hope this (and the attached link) helps.