Choosing the best breast implant size is one of the most important decisions when considering breast augmentation. Generally, I think we do a very good job with this in our office.
The use of sizers, silicone implants that we put in a bra to help a patient visualize what they will look like at a certain size, works well for almost all of my patients.
If we don’t get it right, it’s usually for a reason you might not expect. Let me explain.
Prior to surgery, many women are concerned about going too big.
This is a natural and very real concern. Most of the time when we are doing sizers we are able to counsel patients about what looks good. While it is not our style to tell people what size they should use, we will tell them if we think they are not going big enough to be satisfied with their result, or if they are going bigger than is feasible.
It’s easy to forget where you were before the surgery.
Let me begin with saying that I believe that patients are very honest when saying what they want or don’t want. But, for some women, after they go through the process of choosing the implant size, having surgery and seeing the result, their expectations change. What might have seemed like a huge increase in size may now seem OK a month or two after surgery. It’s human nature. Once you’re used to a new normal, it’s no longer quite the change you first thought.
Sometimes we’re trying to hit a moving target.
Changes in expectations can be difficult to deal with. This is a situation where bigger is not always better. It is hard to make a case for being bigger than a D (or Victoria Secret DD) for most people. Going larger may mean that blouses gape at the buttons and finding clothes to fit becomes more of a task. Likewise other women are still concerned about overdoing it and being too big even though – after surgery – they are the size they wanted to be at the beginning of the process.
It’s safe to say that what seems to be the right size may change – both up or down – as the process goes forward. While it is common for women to say that they would go a bit bigger if they were to do it again, most agree that the size that they chose works well for their bodies.
If you already have implants and want to go larger, it becomes more complicated.
Perhaps the situations where it is most difficult to zone in on the correct size is when we are dealing with someone who already has silicone breast implants and wants to go larger, or have a breast lift and go larger. Here, obviously, sizers don’t work as well. So, we have to really discuss the desires of the patient to extrapolate from her current implant size just how much larger she wants her new implants to be. This is especially difficult when were we are dealing with someone who does not know what size her existing implants are and we are unable to get ahold of her records.
The task for me is to really try and get inside the head of my patient to understand what they want. I do my best, but sometimes it’s a challenge. Here’s a case in point.
I saw a woman who wished to increase the size of her implants. She wanted to be a C or D cup. After we discussed the process at length, I chose the size implants that I thought would get her there. In talking with her after surgery she was unhappy about not being large enough even though she was fitting into a DD bra. She said that she really didn’t look any larger than before. This seemed impossible since we had doubled the size of her implants.
She said, “I don’t look any bigger now compared to how I looked in the bras I was wearing before.” Then she showed me a very padded bra that she used to wear. My problem, I realized, was that I was evaluating her starting breast size by what she looked like without a bra- that is to say her anatomy, while she was thinking about what she looked like in a very padded bra! Obviously, we miscommunicated.
Here are some important things to keep in mind:
- There is no “perfect” size. Rather, there is a range of sizes that will work well.
- It’s a process and your expectations may change as you go through the process.
- Use your anatomy as a baseline, not how you look in a bra.
- Bigger, after a certain point, is not necessarily better. Sometimes it’s just bigger and can actually make you look heavier in the upper body rather than bigger in the breast.
- You are going to have these implants for a long time. So you need to take into consideration how the size
and weight of the implants will impact your life over many years.
All the best,
David B. Reath, MD
PS: Have you seen the animated video our office staff produced?
More Sizing Suggestions From Our Staff.
- You may have noticed that this blog is Part 2 of Picking the Best Breast Implant Size. The first part encompasses the helpful basics which we’ve already published our website. If you haven’t read it yet, definitely check it out. How to Choose Your Breast Implant Size
Breast Implants: How To Know When You’re Going Too BigA recent phenomenon that I have noticed is that women are choosing larger and larger breast implants when having breast augmentation. This is something that has gradually increased over the years that I have been doing breast surgery. And I am left with two questions: is there an upper limit in sight? And, how big … Read more
Breast Implants : When To Revise Your SizeRecently RealSelf Trends published an article “Smaller Breasts Are In – Particularly For Women After Menopause” which has gotten me thinking. I guess the question is do women really desire smaller breasts as they go through life? While it would be attractive to come up with a simple answer, I think that the choice of breast … Read more
Think Timeless, Not Trendy, When Considering Plastic SurgeryYou may have noticed that the popular media has been very butt-focused lately. Nicki Minaj at the VMA’s, Meghan Trainor’s catchy hit All About the Bass, Kim Kardashian’s racy magazine cover, and pop stars like Beyonce’ and Jennifer Lopez have all been at the forefront of what People Magazine is calling “The Year of The … Read more