Choosing the right sized implants: how to choose the right size for patients who already have a lot of breast tissue/breast fat?

Cup sizes are not standard across bra makers, and implant sizing is NOT based on height, weight, BMI, or desired cup size.  This is something you will need to do IN PERSON with an experienced surgeon to determine what works well for you, and to get advice about if what you like is possible and what to expect with regards to results.  Be sure to discuss your goals and concerns with your board certified plastic surgeon and consider the pros and the cons. Be certain your surgeon is properly certified.  I've attached a link where you can start your search.  

It is very difficult to determine the best size you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because 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 difficult to make this determination. For example, the existing 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 breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implant
#toobig #breastimplant

Thank you for your question.  You are not alone in your concern about implant selection and questioning how you can feel most confident with your choice going into your procedure.  What I have found over my many years of practice is that the best aesthetic outcome is the result of careful planning and clear communication with regards to patient goals, expectations and any limitations in achieving a patients goal.  To help achieve this I routinely use 3D imaging with our Vectra system and physical implant sizing in my practice to help patients see what they will look like in a variety of implant sizes, shapes and profiles.  While this imaging is never 100% accurate, it does provide a patients with a pretty realistic idea of what they can hope to achieve and I have found that it helps .  Without seeing you in person it is difficult to say whether or not a 250cc implant will provide you with the result you are hoping for but I would encourage you to discuss your concerns with your chosen plastic surgeon because you should approach your surgical date with great confidence and excitement.    I hope that you find this helpful and I wish you all of the best!