Needing to Know What Size Implants to Get to Fix Asymmetry? (photo)

I am 5'1" about 119lbs. My breast are very asymmetrical and have been that way since I was born. I want to still look natural but want to finally fill out a 34-36A bra. I was told to go to 300cc's but am afraid of looking like Pamela Anderson due to my tiny frame. I also don't want them in the way when I workout, but I want to look nice in my clothes too. My surgery is scheduled for Tuesday Nov 13th, 2012 so I need advice soon :) Thanks for any help offered. Blessings!

Doctor Answers 10

Size asymmetry is common and that is why different implant volumes are frequently used.

Congrats. You obviously keep in great physical condition.  It is not unusual for one breast to be bigger than the other.  The plastic surgeon uses a larger volume on the smaller side, so you can expect to have implants of different volumes, which is quite common.  Did you mean A bra or C bra?  I would think a small or moderate C cup would be your objective.  I caution women not to go smaller than a C cup because they will likely wish they had gone bigger later on.  Have a look at my website and you can review some patients with different sizes.  (See if you think M.L. looks too small).

Kansas City Plastic Surgeon
4.7 out of 5 stars 56 reviews

Size IS the most Important Decision

If you are still unsure about your size (which it sounds like you obviously are), then be very very vocal about this with your plastic surgeon and his/her office staff. One thing I know for sure, after 17 years and thousands of breast implants, is that size does matter. It matters a lot. If you don’t get the size right, you probably won’t be too happy with the outcome of the procedure. In fact, I advocate that women who choose to have breast augmentation choose the best size implant together with their plastic surgeon and THEN work every other decision around that decision.

This is not to say that bigger is better. In fact it is not. The important thing about breast implant size is to select the best size for each woman. This is where things can get a little tricky, because women are all so different in where they start and where they want to go with breast size. For example, I could have 10 women walk into my office who have identical bodies, and each could choose a different size breast implant, and each could be happy with her selection. This is because a single size is not necessarily appropriate for a given body or breast size. Each plan must be individualized to that woman’s personal goals of how big she chooses to be, taking into account where she begins. And, this is why knowing your height, weight, starting breast size, and desired final size are not always that helpful.

In order to find the size that is best for any given woman, I recommend the following steps:

1. Use silicone sizers. Even if you want saline implants, silicone sizers are the best. I used to recommend rice in baggies, but it just does not conform to the breast the same way. When using sizers, wear a tight-fitting sports bra (preferably 2 tight sports bras). The reason for the tight sports bras is because anything else will allow the sizers to appear larger than they actually are. Hence, a woman wearing looser bras or a cupped bra is very likely to select a size that is smaller than the size she truly desires.

2. Wear several different tops with your breast implant sizers in place to see how you look. Keep in mind that tighter clothes will always make you appear larger, and loose clothes will always make you appear smaller – no matter what size you select.

3. You may end up liking several different sizes. This is common. I recommend that you select the largest of all implant sizes that you like, stopping just short of the first one that is too big. This is soooo important. Here’s why: most of my patients are sitting on a fence with implant size. They want to go large enough so as to make the operation worthwhile, but they do not want to go so large that others notice or that they feel uncomfortable or that they are disproportionate. My strongest recommendation for women who wish to strike this balance is for them to select that very largest size that they like – but not one that is too big. Ever since I began advocating this approach, my rate of revision for change in size has dropped well below 1%, whereas the national average for revisions for change in size is between 10-20%. Of the few patients of mine who have chosen to undergo breast implant revision for change in size, half have chosen a larger size, and half have chosen a smaller size.

4. When you are viewing yourself in the mirror with sizers in place, be aware of the constraints of an established self-image which you might need to overcome. This is especially true for women in their 40s, 50s, and 60s who have become accustomed to looking at their modest sized breasts for decades, but it can also be true for younger women. I recommend that when you view yourself with sizers, you try to imagine that you are looking at the body of another woman rather than yourself. This helps make the decision-making process slightly more objective.

5. Include your husband, boyfriend, sister, neighbor, cat, etc to help and offer their opinions and support, but be careful to avoid putting the size decision on them. This is especially true of boyfriends and husbands who may feel that if they help you decide, they will be to blame if you do not like the final size. So, my advice is that you should bring them along, but do not press them to give you input if they are hesitant to do so.

6. Ask your plastic surgeon to help you correlate breast diameter with implant size if you wish to be proportionate…but be careful with this, as there are many pitfalls with this approach. This may be the topic for an entire blog of its own.

7. Try to avoid using your desired cup size as a way to select implant size, as cup size is not standardized. The main place that cup size is relevant is with regard to selection of implant profile, but again, that is based on other factors as well…perhaps the topic for yet another blog.

8. If your plastic surgeon does not use sizers or if your plastic surgeon tells you that he or she will select your size, be wary. Most plastic surgeons will choose sizes that most women would be pleased with, but this does not help women who fall outside of the bell curve in their desires to be either larger or smaller than “most” women. Also, some plastic surgeons impose on other women their own perceptions of ideal breast size, which can sometimes be alarmingly large or disappointingly small.

Now, having asserted that size is the most important decision in breast augmentation surgery with regard to satisfaction, here are a few caveats:

1. Please do not torture yourself over 30cc. For example, if you like the 360cc implant, you will like the 330cc implant as well as the 390cc implant. If you end up deciding that the 360cc implant was too small, then the 390cc implant would have been too small also. If you end up deciding that the 360cc implant was too big, then the 330cc implant would have been too big, also. Thirty cc is a relatively negligible amount, equivalent to 2 tablespoons. So, once you have decided on your implant size (or range), know that in order to change size in any visible way, you should change by at least 100 cc to be able to see the difference. (By the way, cc=cubic centimeter and ml=milliliter. One cc is the exact same as one ml).

2. I view each woman as having a range of sizes that will all work well for her and will give equally satisfying results. So when I say that we need to get the size right, I am talking about a range rather than a specific size. That range may be 50-100 cc in either direction of the size selected – even taking into account that the woman selected the largest size that she liked among all sizers.

3. Just getting the size right does not guarantee satisfaction, as other issues exist as well. See the rest of this site for details of all of the other factors that play a role in breast augmentation results.

I wish you the very breast (I mean best) of luck with this! And again, do not hesitate to postpone your surgery until you rae confident that you have the right size for YOU!




Jean M. Loftus, MD, FACS


Jean Loftus, MD
Cincinnati Plastic Surgeon
5.0 out of 5 stars 16 reviews

Best Breast Implant Size for Me?

I think you will be best off spending additional time with your plastic surgeon communicating your goals. As you can imagine, without direct examination and a full communication of your goals, online consultants cannot be helpful in providing specific advice.

 The best online advice I can give to ladies who are considering breast augmentation surgery 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 “C cup”  or “Pamela Anderson"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.

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. 

Best wishes with your upcoming surgery.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Volume Asymmetry Corrections

    Volume problems in breast augmentation are not trivial issues, and simply increasing the volume of one implant may not be the best solution to the problem.  Small differences in volume of 50 cc or less can be managed this way. Often differences greater than this need to have a different management or accept some degree of size mismatch or shape mismatch.  Kenneth Hughes, MD Hughesplasticsurgery Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

What size?

Thanks for your question. I would say the  size mentioned are within the ballpark to achieve a natural augmentation. The bigger you go, then the less likely it will look natural, specially with your tiny anatomy. Consider all your size options. Remember that, the final cup is better determined after performing an examination and seeing your natural shape and current breast volume. Using a volume sizing system (VSS) will help you feel more comfortable deciding from your choices.  Best wishes, Dr. Aldo.

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 201 reviews

Preoperative Consultation

Communication between patients and their Plastic Surgeons is critical to ensuring a good, rewarding experience.  I would immediately schedule another consultation with your surgeon to go through a sizing protocol with measurements, sizers placed inside a bra beneath a tight shirt and even an imaging program (if they use one) to determine the optimal implants for you.  Using different sized implants is common to correct asymmetries and 300 cc's doesn't sound too big for you (at least for your smaller breast) but make sure you and your surgeon are on the same page...otherwise, you may be sorely disappointed!!!

Eric Sadeh, MD
Manhattan Plastic Surgeon
4.2 out of 5 stars 57 reviews


The profile of the implant will determine your look and not necessarily the volume. Most if not all women have preexisting asymmetry.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Needing to Know What Size Implants to Get to Fix Asymmetry?

Sorry can not answer with out frontal nude posted photos. Better yet seek in person evaluations to determine what you need. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Beast Augmentation To Fix Asymmetry


Thank you for sharing your photo.

Unfortunately without a physical consultation it is not possible to provide you with a solid advise tailored to fit your goals.

With that perspective, discussing a potential lift at this point may not be feasible.

However, it is common to resolve a natural breast asymmetry by choosing different sizes of implants where the smaller breast will accommodate the larger implant .

That being said, please remember that commendable results require an exceptionally skilled surgeon to perform the surgery and settling for anything less than that increases the chances of additional corrective surgeries dramatically.
I hope this helps and please feel free to check the website below.

Thank you for your inquiry.
The best of luck to you.

Dr. Sajjadian

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 195 reviews

What Size Implants to Get to Fix Asymmetry?

Unfortunately, the photo submitted is not really of any help. I couldn't even say from the photo that there is asymmetry. I don't know if it is merely a size difference or a difference in shape and nipple/areolar position. If the sizes are different, your surgeon should be considering different sized implants unless the size difference is trivial. 300 cc will probably increase your size by more than one cup size. 

Thanks for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 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.