How do I help my plastic surgeon find the perfect size for me?

I think I am definitely getting hung up on what size I want to be! It's no fun having sleepless nights thinking over and over what size I should be Is it okay if I didn't bring pictures of what I want to look like? I have hundreds of pictures and can't narrow them down, Should I use the pictures they supply me with and point and choose which ones I prefer? Do all surgeons have "sizers" to try on? Do I bring my own clothes? Does the vectra help at all? tips on helping dr.?

Doctor Answers 23

The right size implant

This is a very common question for women considering breast augmentation.  A lot of this answer depends on physical measurements that your plastic surgeon will take during your consultation.  This is called tissue based planning.  Using your body measurements and the assessing the quality of your tissues will help your surgeon accurately determine the ideal range of implants for you.  Pictures can help to show your surgeon what "look" you are going for.  Vectra and other imaging systems can be helpful, but remember they are just computer renderings, and not reality.  Best of luck!


Long Beach Physician
5.0 out of 5 stars 12 reviews

Breast Augmentation: information

Dear Ms. Ashley_yvonne3,

Thank you for your story and question. Many factors need to be taken into consideration than just your desired breast volume. 

Nothing substitutes for a personal evaluation and a face to face discussion of your options.

Unfortunately without photos, a exam of your tissue and measurements I can give you general information that I hope you find helpful.

There are many decisions both you and your Plastic Surgeon needs to make.

Based on your questions my answer to your specfic questions are:

1) I in general prefer that implants be placed under the muscle (dual plane) because of the lower incidence of capsular contracture and the coverage the muscle provides.
2)I would advise round silicone gel filled implants (the profile to be determined by your chest measurements: see below)
3)Volume size to be determined as described below
4)the inframammarry incision is associated with lowest rate of post operative capsular contracture.
5) At your preop appt. and on the day of surgery bring several model photos of what you want your final breast appearance to look like
Your final decision should be based on personal consult with a Bd. Cert. Plastic Surgeon who will examine you and go over that which is best for you. The following are some of the topics you may want to discuss and why.

General overview of your choices and discussion points:
IMPLANTS
1) normal saline fill vs silicone gel fill
2) profile: low profile to high profile (choice based on chest measurements)
3) shape: form stable vs round
PLACEMENT OF IMPLANTS
1) sub pectoral, dual plane
+ less chance for internal scarring (capsular contracture)
+ padding from the muscle therefore less chance of implant palpability (rippling)
- varying degree of animation upon pectorals major contraction ( breasts moving)
- longer immediate recovery
2) supra pectoral
+ in borderline ptosis (breast sag) can provide alternative need for mastopexy
+ faster immediate recovery
- increase chance of internal scarring (capsular contracture
- increase potential for breast implant palpability (rippling)
ACCESS INCISION
1) periarolar
2) inframammary
3) axillary
BREAST MOUND
1) symmetrical
2) equal size
3) breast fold location
NIPPLE/AREOLAR POSTION
1) normal
2) high
3) low
4) symmetrical
5) too large
SKIN QUALITY
1) stretch marks
2) thin skin
3) elasticity
SIZING
is a very personal choice
1)implants come in "cc" sizes not cup sizes
2) 30 cc = 1 ounce
3) purchase a full bodied, non padded bra and take a nylon stocking and fill until you reach the desired size you desire....measure the volume using a measuring cup and convert to cc's.
COMPANIES
I personally choose the company that the breast implant base measurements and match to the patients chest measurements. Sientra only makes Silicone Gel filled implants. Ideal only makes Normal Saline implants (with internal baffles). Allergan and Mentor make both silicone gel and Normal Saline filled implants.
1)Allergan
2)Mentor
3)Sientra
4)Ideal

Please bring several model photos of your desired breast appearance and a list of questions to your consultative appointment and make sure your Plastic Surgeon is Certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).

Best wishes,

Dr. R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
wwwimagineplasticsurgery.com
4646 Brockton Ave
Riverside, Ca 92506
(951) 686-7600

How do I help my plastic surgeon find the perfect size for me?

I allow patients to try on implants in the office.  There is no substitute for this.  Your surgeon should be able to guide you to the precise size.  There should not be stress in this decision.
Find a board certified plastic surgeon who has performed thousands of these procedures and has hundreds of pictures and reviews.

Kenneth Hughes, MD

Beverly Hills, CA

Breast Augmentation/ Breast Implants/ Anatomic Gummy Bear Implants/Silicone Implants/Revision Breast Surgery

I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.

Silicone will give you a fullness at the top (upper pole fullness).
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Your future breasts

Photos of desired sizes help.  We allow patients to "try on" sizes in the office under a sports bra and t-short to get a good idea of what they want.  Most women after a breast augmentation will tell you they wish they had gone a little larger.  Keep this in mind when you chose your size.  The role of the plastic surgeon is to assess what size limitations there may be and chose the appropriate shape (projection) of the implant to make the breasts as pretty and natural looking as possible.

Tim Neavin, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 31 reviews

Size choice

Hello,

Thank you for your question. Your precise measurements will determine the implants which fit you the best. You can also show your Plastic Surgeon some pictures of the look you are after so that they have a good understanding of your aesthetic goals.

My patients find it helpful to try on the implant sizers with a form fitting T-Shirt in this office in order to get a good idea of what they will look like. I recommend that you choose the implants which you feel most comfortable and like the look of. You will be the best one to determine what meets your needs. 


All the best

Perfect size implants

It is important that you pick a size that is perfect for YOU. Many surgeons will have their own way of determining what they perceive to be the best fit for you given their experience. You can call your plastic surgeon ahead of time and ask what you should bring with you to help make a decision. If you do have photos of people of similar build as you with breasts you prefer, you should definitely bring them with you as they can only help describe what you are looking for. 

Johnson C. Lee, MD
Beverly Hills Physician
5.0 out of 5 stars 12 reviews

Implant size

As far as choosing the correct implant size for augmentation, you and your surgeon need to communicate.  However, at the time of surgery, many of us put various "sizers" of implants in the incision, and out of the incision -- and see what size is best.  You are limited in  implant size depending on the amount and shape of your breast before the surgery.  Keep in mind, you can't put a size 5 foot in to a size 4 shoe.

Implant Sizing

Hello,
In office sizing with sizers placed in an unpadded bra under a shirt will give you and your surgeon an idea of how you want to look. This is better than photos, and it's better than the 3D imaging devices available.
Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

How do I help my plastic surgeon find the perfect size for me?

The answer is quite simple. Just show the surgeon several pre and post op photos of patients with your anatomy and post op look you prefer. An experienced and artistic surgeon should have no trouble in getting that look for you. Trying implants on in front of the breast in the office is of little value in final sizing. That requires the use of sizers in the pocket during surgery. The size of the implant is unimportant. The only thing that matters is the look of the finished result of the implant behind your tissues plus the look and volume of your natural tissues in front of the implant. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 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.