How do I pick a breast implant size (breast enlargement) without having back pain?

    You are going into surgery being thoughtful about repercussions of size on long term health, which is commendable.  I think that you should start with sizers in the office to determine the size with which you would be happy.  Then, the weight of the implants for that size can be determined.  In general, back pain tends to occur with women who are a D cup or larger.  Your surgeon should be able to steer you to the right size based upon these parameters.Kenneth Hughes, MDLos Angeles, CA

There is no way to guarantee a particular bra size. Bra sizing varies greatly between bra manufacturers and a C in one bra will be a D in another. What matters more than the assigned bra size is the way the implant looks on you. The best option for your body and aesthetic goals can be determined in a thorough implant sizing session.Implant sizing depends on several factors. One of the most important factors is your breast width. Generally, your surgeon will measure your breast width, and then provide you with a range of implant sizes appropriate for your native breast size. There are more nuances to it than just what I've described, but this approach works for most women.I usually have my patients bring in a large bra and a tight t-shirt to do sizing. I'll then choose 3-4 implants that I feel are appropriate, and have my patients place them in the bra under the tight t-shirt. My patients can then look in the mirror and get a good sense of what they will look like with the provided implant sizes. My patients like this approach and get a great idea of how they will look.By using this technique, your surgeon can outline a range of appropriate implant sizes that will be aesthetically pleasing, and you make the final decision.I hope this helps. Good luck!

In my opinion, too many women get implants that are too large.  They may like them initially, but with time, the larger they are, the more they sag and become a burden.  Given your build, I would probably use around 350 cc implants. That makes most women a mid to full C cup.

Your concern about back pain from large breasts is a valid one.  The best way to minimize the chance of having back pain from breast implants, along with minimizing the chance of numerous other possible complications, is to not have too large of an implant placed.  It is impossible to give you a breast implant size without some more information.  Proper implant selection depends on several factors such as certain breast measurements and skin quality.   The best way to sort all of this out is with a consultation and physical examination by a plastic surgeon certified by the American Board of Plastic Surgery.  I hope that helps

Thank you for the questions. However, despite good intentions, online consultants will not be able to provide you with  meaningful specific advice.  Ultimately, in person consultation with well experienced board-certified plastic surgeons will be necessary. Careful measurements, dimensional planning, and careful communication will be key.
Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) 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 which operation and/or 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 "small C cup" etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.  The use of computer imaging may be very helpful during this communication phase.
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.
I hope this, and the attached link, helps.

In our experience, the best way that we have found to guide our patients' choice of implant sizes is to do a meticulous formal sizing exercise with breast implant sizers before surgery.  This way the patients aren't left guessing if they will have a C cup or D cup or DD cup, and we don't really have to worry about implant volume as a primary concern.  That is to say, the main thing is for the patients to look at themselves in the mirror with various sizers in their bra with a  close fitting t-shirt and decide which implant size creates the best proportion and "fit" for their individual bodies.  The sizers are specially designed for this purpose, and they give very accurate information.  Once that is determined, it doesn't matter what the postoperative cup size is; it will be the bra that fits the breasts that the patient likes.  This can also give information about the heaviness of the breasts with that size implant, and this can be factored into the choice.  Gudrun, my R.N., is expert at helping ladies with this decision, and I find that having her work one-on-one, female-to-female with each individual patient, gives us the best information about this in the most comfortable way.  We have been doing it this way together for years, and we rarely (not never, but rarely) have to return to the O.R. just to replace implants for size.  Good luck!

Thank you for a question. Your concern is a common one expressed by many patients.  Back pain after breast augmentation is an infrequent complaint provided that you pick an implant that fits your frame.  Women that have back pain frequently pick implants that are too large for their frame. Based on your aesthetic goals it does not sound like you are wanting a very large implant. Find a board certified plastic surgeon in your area and express your concerns and they can help you pick an implant that works for you.