Post Breast Augmentation Size - Surgeon Talked Me out of my Desired Size?

Had BA 2 weeks ago. Upset with size outcome. Gave surgeon a picture at my consult. She asked for a more detailed pic and said I could bring it day of surgery (wow, day of?). Ok, day of surgery brought 2 pics of exactly what I wanted. She disagreed with the size (I wanted a D), and she talked me down to a C. I kept pushing upward and she said maybe C+ and left. Surgery done 30 mins later. Result: small C at best & can wear old bra size. Money gone; I've cried over it. Want re-do. Advice needed.

Doctor Answers 15

Preoperative Goals Important

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Unfortunately, your story is common.  You should always go through an extensive sizing protocol before deciding what size implants you want.  This should include measurements of your chest/ breasts, placement of sizers within a bra underneath a T-shirt and even at times 3-D imaging.  It's equally important to find out whether moderate or high profile implants would give you the size and shape you desire.  

Don't despair, a simple revision can enlarge your breasts to where you want them...your PS should give you a sweet deal to replace them...good luck! 

Manhattan Plastic Surgeon

Revision breast augmentation can make you larger.

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I can understand your frustration. Many surgeons do not charge another surgical fee for a revision.  If in doubt, get another opinion.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Unhappy with implant size

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You should speak with your surgeon about your dissatisfaction and see what they are willing to do.  There may have been anatomical reasons larger implants could not be placed.  Your surgeon should be able to explain this to you.  Bra sizes are not something that is predictable, since each bra manufacturer is different.  Trying on sizes and the use of imaging may have been helpful, if available, preoperatively to determine the look you we're after.  Perhaps a higher profile implant may have allowed your to get more volume in a narrower breast width space.  Something to consider if you decide to change your implants in the future to a larger size.

Todd C. Case, MD
Tucson Plastic Surgeon

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What to do?

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Hello and thanks for your post. This scenario is quite common and when it comes to size you can't always get what you want. At least, not in the first operation. The most likely case is that your frame is simply too small for a D cup or the size of breast implant you desired. The surgeon simply may not have been able to fit the size you desired at this time. Photos and a description of your height and weight can help to identify if this was the issue. Your breast implants now will stretch the tissue and eventually you could switch to a bigger size, but only after 6 months or a year. Speak to your PS about your dissatisfaction. Best wishes, Dr. Aldo.

Aldo Guerra, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 215 reviews

Breast size after augmentation

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Predicting breast ,bra size before surgery is not an exact sience, It doesnt matter how many photos or simulators you use,it depends on the patients anatomy and the size and position of pocket that can be made for the implants. Giving the patient a range of sizes and using sizers intraoperatively is the best way to avoid this problem. Even with that much planning their will be some unhappy patients, I have them wait 6 mos. then the tissue has been stretched bigger implants can be placed, the patient pays for new implants and o.r. expense.

Terry A. Cromwell, MD (retired)
Lafayette Plastic Surgeon

Unhappy with size

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Unfortunately, no one can guarantee you a cup size.  First, there is no correlation between volume used and ultimate cup size.  Second, bra manufacturers do not have standard cup sizes.  With that in mind, I would suggest that you discuss your unhappiness with your plastic surgeon.  It is in her best interest to have a happy patient out there who will refer more patients to her so I am sure she will do her best to help you get to the cup size you want to be.  Also, since you are already her patient, she can give you the best price for a re-do if that is necessary.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 26 reviews

Unhappy with surgeon's pick of size

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Photos would have helped the gallery determine if your body could have handled a larger implant.  Assuming it could have, it perplexes me how surgeons often pick the size for patients and are often off the mark.  You should have had the opportunity to 'see' what you would be like with external sizers.  And you should know the revision policy of your surgeon as it would be needed in such situations.   I hope you are able to resolve this with your surgeon but if not, then get a second opinion and a copy of your records to take to whomever you see.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Picture for Advice byVillar

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Post a picture of before and after for better advice.  Best wishes. Knowledge is power  Luis F. Villar MD FACS

Luis Villar, MD, FACS
West Palm Beach Plastic Surgeon
4.4 out of 5 stars 11 reviews

Size after breast augmentation

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Thank you for your question.  Sorry to hear you are not happy.

It is not possible to give accurate online advice regarding best implant size and style. 
The best online advice I can give to women who are considering breast augmentation surgery is: 


1. Choose your plastic surgeon carefully.  Concentrate on appropriate training, board certification, and the ability of the plastic surgeon to understand and achieve the results you are looking for. Before and after photos should be made available either at the consultation or on the surgeon’s web site.  Remember, however, these will be chosen for good results.  Photos are marketing materials. 

2. Have a complete discussion regarding your desired goals with your plastic surgeon. This communication will be critical in determining what breast implant type, size and profile will most likely help achieve your goals. 
Bringing photographs of women who have the look you are interested in and some that you don’t like as well are helpful.  I do not believe that photos are helpful in determining implant size.  Terms such as “natural” or “D cup” or “perky” etc. have different interpretations and are therefore not helpful.
 Also, as you know, cup size varies with the manufacturer and the chest size, which makes discussing desired cup size problematic. 


3.  Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his experience and judgment to choose the breast implant type, size and profile that will best meet your goals.  In my practice, this decision is made prior to surgery using a specially designed set of implant sizers so the patient has a very good idea of how they will look after surgery.  Most of all we want you to like the way you look after surgery and after surgery when you start buying bras you will find what size fits best.

4.  There are quite a few questions on this site dealing with a description of body size and shape and bra size, requesting assistance with implant size.  Everyone’s body is different and choosing a size implant is ideally based on the size and shape of the breast, and the tissue characteristics of each individual patient, as well as their desired goals.  Many women may not be able to achieve the results they want without using an implant that is simply too large which often results in problems many of which require additional surgery.

I suggest to tell your surgeon that you are not satisfied.  In all likelihood the appropriate size implant was used for your particular body. If you showed photos of something that was not obtainable you certainly did not want your surgeon to put in an implant that was to large for your body just to match the photo.

Best of luck.

Ralph R. Garramone, MD
Fort Myers Plastic Surgeon
4.8 out of 5 stars 69 reviews

Not Happy with Breast Size after Breast Augmentation?

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I am sorry to hear about your dissatisfaction after breast augmentation surgery. It sounds like your  communication with your plastic surgeon, especially given that it what was “last minute”, was less than ideal.

 At this point, best to communicate your questions, concerns, and goals with your plastic surgeon in a calm and constructive fashion. Ask her why she felt a larger breast implant could not have been utilized;  you may find that there  may have been anatomical/measurement concerns. Sometimes, depending on the patient's specific situation, it is not possible to achieve a desired goal without risking complications such as breast implant displacement/malposition  and/or breast implant rippling/palpability.

 Hopefully, you will be able to work together to achieve your goals, if safely possible.

 Best wishes.

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.