How does a doctor determine the max size implant for a patient? Does stretched out skin mean a larger implant can fit?

Thank you for your question. Your surgeon will determine the maximum implant size based on several factors, including breast width diameter, skin and soft tissue elasticity, the structure of the implant pocket, and the ribcage shape. If the skin is stretched, it can accommodate a larger implant, but thin skin increases the risk of rippling, bottoming out, and the implant's visibility. If your skin is already thin and stretched due to your 375cc implants, opting for larger implants could exacerbate rippling, increase implant visibility, cause the implants to drop too low, and worsen nipple positioning. In such cases, procedures like capsulorrhaphy and fat grafting may be necessary to improve soft tissue coverage and reduce the risks of rippling and visible edges. Consulting with a breast revision expert can help create a suitable plan for you. Based on the examination, the appropriate implant size and profile can be determined, along with any necessary soft tissue modifications, such as a revision lift.

Dear ashez916,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient.
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery