Assessment of breast size is highly subjective, and I typically avoid using cup size when communicating desired breast outcome. Implant decisions should be made with your surgeon. Each provider will have their own way of guiding patients through implant selection. Different providers will approach this differently. Some providers will ask patients to Make the final decision while other providers will make the decision based on input from the patient. My personal preference is to work with a lot of before and after pictures to get a clear understanding of what the patient desires Esther final outcome. Once I have a clear understanding of what the patient is, hoping to achieve by reviewing numerous before, and after pictures of previous patients, who are very similar body characteristics, I bring those pictures to the operating room. During surgery I use temporary sizes to determine what size implants will create an outcome consistent with with the patients ideal outcome. I find this to be the most consistent and accurate. Some providers prefer to have patients make the final decision which puts the responsibility in the hands of the patient rather than the provider. In my opinion to provider is in a better position to make the decision, since they are working within their profession, and have far more experience with implant Sizing, then patients typically do. I typically do not like communicating using milliliters cup sizes or inches, but prefer to work with pictures. If you’ve selected a plastic surgeon that I suggest discussing this topic with him or her. If you’ve not selected a provider, I suggest scheduling multiple in person, consultations with plastic surgeons in your community who seem to have a lot of experience with breast augmentation surgery. Ask each provider how they go about making implant decisions. During each consultation, ask each provider to open up their portfolio and show you the entire collection of before and after pictures of previous patients who had similar body characteristics to your own. An experienced provider should have no difficulty showing you the before and after pictures of at least 50 previous patients. Being shown a handful of pre-selected images, representing only the best results of a providers career may be insufficient to get a clear understanding of what average results look like in the hands of each provider, what your results are likely to look like, or how many of these procedures they’ve actually performed. There are generally three variables that determine quality breast augmentation outcomes. The first is the patient’s candidacy for the procedure. Not all women are ideal candidates for breast, augmentation surgery so results will vary based on candidacy. The second variable is the choice of implants in regards to size, shape and type. The third variable is the surgeons ability to technically placed the implant in the correct anatomic location. Best, Mats Hagstrom, MD