Why do they add 60cc on top of the implant sizer? Which number do I go off of to compare—before or after the 60cc?

I am not completely certain what you are referring to, but I have a good idea of what's going on. In the days when I used implants in bras to simulate the desired size for a breast augmentation, we would add volume to the implant choice for the implant that would be used. If you liked a 300 cc implant in a bra, we could likely get that result with between 330 and 360 cc. Why? because the bra has empty space that's neither breast or sizer implant. It's air. So in effect, we would up-size as a "fudge" factor of 10-20%. It's still a decent option for sizing.Currently, I use silicone sizers which are much better at simulating the final result. These sizers are differently shaped so that there's only breast and sizer in the bra,no air. So a 300cc sizer gives a good simulation of a 300 cc implant in place. My favorite technique is the use of a Vectra three dimensional photographic system. That device takes a three dimensional photo of you and allows us to add implant precisely to show what the implant will likely look like. It's also very valuable in cases of asymmetric breasts. It's all a question of which implant will give you the result you wish.

Thank you for your question.
Since the sizers are above the skin, they tend to over estimate the amount of augmentation. When put behind tissues, the projection and the size decreases by 10-20% depending on the placement. The size is effected more when the implants are put behind the muscles compare to when they are put in front of the muscles. This is probably what your surgeon is talking about. You should, however, discuss this with him at length. All The Best !

hello thank you for your question and provided information as well;..based in your question its difficulted evaluate your case if the question dont have a picture, its recommended to get a consultation in personal with a plastic surgeon.

Thank you for sharing your question. Unfortunately each office will manage implant sizing differently and you would need to ask your surgeon's office why they choose to add 60cc to each sizer amount.  Best wishes on your upcoming surgery.

 I recommend an in person evaluation by a plastic surgeon to be measured and discuss your goals. After I measure and discuss goals with my patients, we then look at pictures of women with similar measurements with different size breast implants. My patients tell me that this process is very helpful in determining what size breast implant is right for them. 
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author RealSelf Distinguished Hall of Fame Inductee

I understand some surgeons when they size you state that the final result is smaller in comparison to the sizing that is done in the office therefore you will need to add "X" amount to the final volume.  I am not sure how much truth there is to that statement as it is impossible to quantify how much volume a patient loses once the implants are placed behind the muscle.The size system we use, we do not add any extra to the size we determine in the office.  Sizing in the office is one aspect of breast augmentation surgery, other aspects are the soft tissue characteristics, the measurements obtained and the general look the patient is striving for.If there is some uncertainty, I would recommend you see your plastic surgeon again.  But the sizes that you are around are not very different from one another.

The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Dear newboobs2002,
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

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. This will ensure that you avoid the dreaded "fake" look. 
With regards to your specific question, I am not familiar with the concept of adding additional volume on top of the selected size. Some do suggest that there is a loss of volume when placing implants submuscular. This is more a function of shape and projection rather than volume. I would recommend further consultation with your surgeon in order to better clarify your choice of implant.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

and its known that if you use the volume of the sizer selected as the implant volume, you will be smaller than what you saw in the mirror with the sizer in your bra.  I routinely add 10% to the sizer volume to get the implant size to be used in the procedure and my patients have achieved the look they saw with the sizer in their bra.  So you must add some to any sizer used externally to help you choose a look you want.