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 Victoria Secret is not necessarily transferable to another brand.

Another point that is often underappreciated is that of anatomy and starting point. Any implant will add volume to the volume that is already present; the implant is additive. A particular volume will not necessarily confer the same cup size to different patients. Oftentimes, 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 that 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 breast width diameter (BWD). This will ensure that you avoid the dreaded "fake" look.

In your case, since you are seeking a more "dramatic" (i.e. less natural) result, your upper limit will be defined by what your skin envelope can accommodate. That being said, it is best to stick to the parameters as defined by your BWD rather than challenge the limits of your skins ability to stretch.

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012

525 will add 2 1/2-3 cups, resulting in DDD. If you want a fake, bowling ball look, I'd recommend you go over the muscle.

Published on Jul 11, 2012

The UHP are definitely the way to go when trying to achieve a more rounded "fake" appearance. In terms of size, without an examination, it is impossible to say what will work the best. It really depends on what your own tissues can actually accommodate. This is something to discuss with your surgeon. I hope this helps.

Published on Jul 11, 2012

Hello and thank you for your question. I want to start off by telling you what I tell many of my patients: Do not focus on cc's or bra sizes, as many women see their friend with "x" number of cc implants and think that they have an idea of what they want. There is a lot that goes into implant selection--your breast volume, the amount of cleavage you want to achieve, your base width, your rib shape/projection, etc. Without seeing you and doing your measurements, it is difficult to assess accurately your final breast size or shape. Please also keep in mind that when it comes to bra sizes, most women are not accurately sized for their bras.

The most important thing to consider is really the size and look that is appealing to YOU with the implants you choose. Many surgeons have sizing models, whether using bras with implants or computer simulation. I encourage you to discuss with your surgeon many of these considerations when deciding which implant and size to use during your surgery. Additionally, a breast implant is a round object and has a certain diameter. Your base width on each side of your chest will determine "how big of a ball" or what diameter implant you can reliably go up to with a socially acceptable cosmetic outcome. The implant will "augment" or increase the size of your breasts to an amount acceptable to you and your surgeon.

My patients will try on a sports bra and then we pick the implants based on their measured breast base width. If your base width were to support for example up to a 600cc implant, I would have you try on the 600cc implants in the bra and then the 585cc or 525cc implants and afterwards select the implant that made YOU the happiest. In reality, don't stress too much as this is not a HUGE difference and should be the fun part of the process. Go with what is acceptable based on your measurements and makes you happiest and make sure to weigh the pros and cons of the options you are considering. You can also compare the high profile with ultra high profile implants and see which look you like most. The profile of the implant will determine how much upper pole fullness and overall projection you portray.

Make sure to seek consultation with a board-certified plastic surgeon with expertise in aesthetic breast surgery.

Published on Jul 11, 2012

The normal cup size volume may be equated to about 150 to 200cc, so a 525cc breast implant may accomplish this if your breast tissue is in the proper position and the implant is placed over the muscle.

Published on Jul 11, 2012

One of my specialties is XL breast implants. Make sure that your plastic surgeon is aware of what you are trying to achieve, for most are uncomfortable going passed a certain size. You don't want to end up having to do more surgeries to get to what you want. We do have a special imaging system that could show you approximately what you would look like with different sizes.

Published on Jul 11, 2012

I do not believe you will reach your goal for a G! Did you discuss this with your surgeon? Perhaps your chest wall is not large enough to accommodate a bigger implant. This is an important issue to discuss with your doctor, especially so near surgery. Show him a photograph of what you want and ask to clarify communication.

Published on Jul 11, 2012

Best thing to do is communicate with your surgeon. I ask my patients to bring in pictures of breast sizes that they like and even dislike. I review these photos with the patient and discuss if it is reasonable given their body type, size, etc. I take these photos to the operating room with me and when the patients is on the operating room table, I use temporary sizers to view how different cc's look on the patient. I sit the patient up on the operating room several times and compare them with the photos that they have chosen. When I see that I have achieved the patient's goals, I remove the temporary sizers and put in the implants. There is no guess work. I have all sizes from both manufacturers available to me at all times. This procedure takes more time BUT gives more exact results.

Published on Jul 11, 2012

At the end of the day, just how big an implant the surgeon can place will be determined by your chest size and how loose your chest wall skin is. You can put a gallon of milk into a quart container.

Published on Jul 11, 2012