Can I Choose 2 Implant Choices Pre-Op and Let Surgeon Decide During Surgery?

At the time of surgery could I purchase 2 implant choices and have the doctor choose the proper fit during surgery procedure?

Doctor Answers 14

Implant choices

The way I handle things in my office is that we decide on a volume and shape of implant,, but I always have available  one size above and one size below just in case I do not feel the size we choose was the best for her.

New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Choosing implants for breast augmentation

choosing implants:

  • some doctors use sizers during surgery
  • show photos of what you would like
  • some doctors will have more than one size available
  • this is not an exact science
  • you can try sizers in a bra preop

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 110 reviews

Can I purchase 2 implant sizes and have the surgeon decide during surgery?

I do not see why you have to purchase 2 different implant sizes. I keep a consignment (as do many plastic surgeons) of implants in all the commonly used sizes and all three profiles or shapes available in our surgery center.  Even if an unusually small or very very large implant were anticipated, we can order these, and we only pay for the final implants that we open...the rest are returned at no charge. I have never heard of making a patient pay for more than one pair of implants so that the surgeon can choose which to use in the OR.


Plastic surgeons vary in how they approach sizing. We have patients try sizers on in a bra before surgery, at the preop appointment, and that gives them some idea of what adding that volume to their current breast volume would look like in terms of breast size. No, it is not perfect, but it is very helpful.  Obviously this does not take into account whether a large implant will look too tight and bulgy in a tight-skinned patient, or whether a too-small implant will properly fill out a loose-skinned patient.  Therefore we help advise the patient during this process.  Also, we discuss contour, how natural a contour a patient desires vs. how much less-than-natural upper pole fullness someone wants.  We encourage patients to bring in photos of breasts they like, NOT because we can match them (everyone's anatomy is different), but because it helps the patient communicate what aesthetic they are aiming for.  Then, in the OR, we have sizers available for each implant size and profile, and we try the sizers in the pockets before making a final decision, and only when we open a pair of implants and insert them are the implants "bought" by the patient (of course they paid for one pair of implants in advance).


Proper sizing is a cooperative venture between the surgeon and the patient.  When either one makes a size decision without the input of the other, that is when problems arise and patients may be unhappy with their results.

Robert M. Grenley, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 87 reviews

Implant sizing

When planning your bresat augmentation communication with your board certified surgeon is critical. Photos demonstrating the look you are hoping to achieve will guide the implant choice. I personally will bring implant sizers to the operating room and see which of the choices best creates the look you desire. Implants are available in different sizes and projections and are decided upon in the operating room based on the preoperative discussion.

You only pay for the implants you use. You would not have to pay for additional implants simply to have them available.

I hope this is helpful and good luck.

Robert W. Kessler, MD, FACS
Corona Del Mar Plastic Surgeon
5.0 out of 5 stars 130 reviews

If your plastic surgeon really understands the look you want, it is his job to pick implants.

How to pick breast implant sizes:


I wrote this article a while back, and I hope you find it helpful.  I do not understand why women think it is their responsibility to select breast implants.  It really requires training and experience.

1)  This is the most common type of question on RealSelf.

2)  It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical.

3)  Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like.

4)  Then your surgeon has to tell you if your chosen look is realistic for your anatomy.  The most common mistake is to go too big.

5)  I recommend that  the surgeon NOT make a final implant choice in advance, because this is just an educated guess.

6)  The surgeon should have a large inventory of different size and shape implants available in the operating room.

7)  Then the surgeon can put sterile disposable implant SIZERS in your breasts during surgery, to see what a particular implant really looks like inside you. This is how to make the best choice. A sizer costs only $45, and takes all the guess work out.

8)  Finally, the sizer is discarded, and the correct breast implants (based on what you want and on your anatomy) are opened from the operating room inventory, and put in your breasts to complete the operation.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Breast augmentation, Implants

You should never go to surgery with just one implant size available. It doesn't matter how good your surgeon is, there will be subtle things about the way one breast implant fits IN you that make it look better or worse than another one that simply cannot be discovered until it is truly in you. That is why sizers are available for intraoperative use. And you would only pay for two implants, not four. Your surgeon will have a large selection of implants available in his or her office. If the ofice asks you to pay for more,  just walk out the door to another office. And by all means make sure this is a surgeon certified by the American Board of Plastic Surgery.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Purchase extra breast implants?

Any surgeon should have a full range of breast implants available during your breast augmentation, and should be able to select the correct one for the look you have determined to be best for you. Purchasing 'extra' implants so he can choose is a big red flag. How about choosing another practice.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Multiple implants

This is an excellent idea. On occasion, we just aren't sure of how easily the pocket can be dissected. This happens frequently with revision surgery when the patient cannot obtain medical records and we have to guess the size of the implants. Multiples can be ordered from the manufacturer and those not used returned for a credit. I do not charge the patient for this. I use sizers intraoperatively so the unopened implants can be shipped back.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 42 reviews

Have multiple sizes available

Absolutely.  I always have multiple sizes available just in case.  I advise my patients that we have a size that we are shooting for and then have one size up and down available.  I also use sizers just to make sure and to avoid opening an implant unnecessarily.

Steven Schuster, MD, FACS
Boca Raton Plastic Surgeon
4.0 out of 5 stars 8 reviews

Implant size

Yes; and this is what I often have patients do.  This allows the surgeon to reach the most aesthetic result.  Donald R. Nunn MD   Atlanta Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 47 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.