The best cosmetic result in anyparticular breast augmentation patient depends on a variety of factors,including: Your individual anatomy, realistic expectations, a thoroughdiscussion with the plastic surgeon about the options, and an understanding ofthe pros and cons of any particular implant choice. Proper sizing is not justabout the number of cc’s. The thickness of your tissue, breastdimensions which include the width, height, and projection, aswell as chest wall width all need to be considered when choosing an implant.Trying on implant “sizers” of various shapes and volumes while wearing a tightt-shirt, bra, or bathing sit at a preoperative visit will help you and yoursurgeon choose the optimal implant.There are no manufacturers' standards for cup sizing in the braindustry. The cups of a 34 D-E and a 36 D-E are significantly different. Cup sizevaries from manufacturer to manufacturer and even within styles from anyparticular manufacturer. Nor is there a direct correlation between implantshape or size and cup size.Keep in mind that following the advice from a surgeon on this orany other website who proposes to tell you exactly what to do without examiningyou, physically feeling the tissue, assessing your desired outcome, taking afull medical history, and discussing the pros and cons of each operativeprocedure would not be in your best interest. I would suggest that your plasticsurgeon be certified by the American Board of Plastic Surgery and ideally amember of the American Society for Aesthetic Plastic Surgery (ASAPS) that youtrust and are comfortable with. You should discuss your concerns with thatsurgeon in person.Robert Singer, MD FACSLa Jolla, California
HI Amy!Here are a few tips for you because this is perhapsthe hardest decision for a patient to make, as well as the surgeon. I will also discuss cup size and implant size. Also seethe video attached to my answer. Balancing the implant to your over-all body shape and tissue cover isessential.The main thing is to have the diameter of the implant fitthe diameter of your breast "foot print". Cup size estimates can be misleading, but I generally advise patientsthat they will experience an increase of approximately one cup size per 200 cc.You can try on implants in the office by placing them into a special bra.The implant is also flattened somewhat when under the muscle, so it is agood idea to bump it up a bit. Approximately 50 cc (1-2oz.) is added to the final volume to account for flattening of the implant inthe partial sub-muscular pocket. Once you decide on a size you like, then addon about 25-50 cc, because in real life the implant will be flattened slightlyby your tissues.Multiple measurementsneed to be taken to fit an implant to your exact anatomy. Have yoursurgeon's office show you the charts of the implant dimensions for the variousprofiles of silicone and saline from the manufacturer. Then you and yoursurgeon can piece together the puzzle by matching your measurements, with yourwishes, versus your tissue cover and the available implants to arrive ata surgical plan.Keep in mindlarger implants tend to have more problems over the years.Since silicone implants wrinkle less thansaline implants, they might be your best bet.You canalso approximate this at home by measuring out an equivalent amount of riceplaced into a cutoff foot of old panty-hose, and put this in your bra.Wear this around the house for a while, andsee what you think.Implant size mustsquare with assessments of tissue cover, breast diameter, and chest wall width.Multiple measurements of your chest wall are taken (seven in total). Implantsize selection has been an issue of much discussion. Therefore, I use a wide variety of methods, but the implant size isalways established preoperatively.Also,patients are advised to bring reference photos demonstrating their ideal sizeand shape. A photo album of patient pictures is maintained to assist them.These photos ultimately help in determining where the implants will be placed,since they can be shifted inside (to provide more cleavage), to the outside, upor superiorly, and down or inferiorly during surgery. In determining the finalsize selection, I always place the highest priority on the preoperative measurementsand potential tissue cover. Then, the patient’s verbal requests are factoredinto the analysis.Our average size overthe last 7,000 implants was 350. 90% of our patients wish theywere bigger a year after BA.I t is like your mind incorporates the "newyou" into it's self-image over a period of time. We usethe quick recovery approach, so click on the web reference link below to havethis explained and you can see the list of Quick (Flash) Recovery BreastAugmentation articles from peer-reviewed surgery journals.Be sureto see only a board certified plastic surgeon (by ABPS - The American Board ofPlastic Surgery) who is a member of ASAPS (The American Society for AestheticPlastic Surgery) and or a member of ASPS (The American Society of PlasticSurgeons). Also, ask if the PS has an established, high volume breastaugmentation practice, performing several hundred breast augmentations eachyear. Be sure the PS has been in practice for a while, about 20-years might bea good gauge.Does the PS offer allthree incisions?Discuss the implanttype (gel or saline), shaped "gummy bear" or non-shaped, smooth ortextured, implant pocket (over or under the muscle) and the "quickrecovery approach."Ask to seetheir before and after photos if you didn’t see any on their website. Ifthey are experienced, they should have several 100 breast implant patients foryou to view. I would also recommend that your doctor offer you the chanceto talk to past patients who would be happy to discuss their experience withyou. You need to feel comfortable, so make sure the environment is safeas in an accredited surgery center. Also, ask a prospective surgeon if he orshe has ever published journal articles in professional peer-reviewed journals,which they can provide you.All thebest, “Dr. Joe”
