Please make a consultation with a board-certified plastic surgeon. You can ask if they have a sizing system or a Vectra system to help you "try on" different sizes until you feel comfortable with a volume/size. When you do go in for a consultation, make sure to bring photos of breasts you like. This can also help the surgeon discuss options to achieve that aesthetic.

Published on Jul 11, 2012

Thank you for your question! There are many different factors that weigh in when determining the best size for a woman’s chest. While many women assume only weight/height are factored in, the broadness of your chest and your chests’ skin envelope are major contributing factors also.

It is best to find a surgeon that will allow you to try the implants on with a full coverage, non-padded bra to give you realistic expectations. From there, you are easily able to try on a few sizes to see what sizing you feel the most comfortable with.

Published on Jul 11, 2012

See a board-certified plastic surgeon who uses Crisalix or Vectra to simulate volumes and projection of the breast as this helps immensely in the sizing decision.

Published on Jul 11, 2012

This is a common issue. The way I address it in the office (as do many plastic surgery colleagues) is to combine examination, measurements, "wish photos," sizing kits from the implant manufacturers, and surgical simulation software (we use Crisalix, some use Vectra or other devices).

Together along with the patient's expressed goals, these methods help narrow the focus to something where the patient and surgeon are usually speaking the same language as far as expectations go.

Here is the advice we give on our website:

"As for implant style and size, often the widest implant that fits the patient’s base diameter and is within the volume range the patient seeks would be best; if a patient selects an unnecessarily narrow or excessively high profile implant, she may end up with wide cleavage or implants that can move too much in the pocket. However, it also depends on the type of projection being sought. In general, implant volume is determined by a combination of estimating the patient’s own breast volume and the target cup sizes, and determining a range of added cc’s of volume that would be expected to achieve the goal. Implants come in a variety of “profiles,” which is a term that describes how much of the volume is used to create width vs. forward projection of the breast. Moderate profile implants are wider and flatter, while high and ultra high profile implants are narrower and taller, and “moderate plus” implants are somewhere in between. A patient with a very narrow chest wall and little native breast tissue is often a good candidate for a high profile implant, whereas patients with a lot of native breast tissue and a wide chest may do better with a moderate or moderate plus implants style."

During consultation, the plastic surgeon will take breast measurements including the chest wall, and will look at whether you need a lift, areola reduction, or other approaches, as these can also impact the implant size that will give you the best result.

There is no “cookie-cutter” approach to sizing for breast implants to achieve a “natural” look, or even a “done” look. Because breasts have significant variability, depending on native breast volume, shape, nipple position, descent (or “sag”), and symmetry issues, what one patient considers natural may differ from another patient’s perception. It is therefore very important to try to explain your cosmetic goals to your plastic surgeon during your consultation.
Pictures of models illustrating your ideal breast appearance can be helpful, but be careful not to assume that there is any guarantee of getting the exact same look. Many patients who end up with an “unnatural” look do so because of poor communication regarding their goals preoperatively; but there are also intraoperative and some postoperative factors that can contribute to the appearance. The dissection of the implant pocket by the surgeon is the most “controllable” factor in determining the final appearance. Using overly large implants for the patient’s chest wall measurements can contribute to an unnatural outcome. In addition, the placement of implants over the muscle may make them more visible and detectable, particularly in patients with relatively small preoperative breast volume. The surgeon must take care to make a well-designed pocket for the implant – not too spacious, and not too tight – and this step is often aided by careful preoperative marking and review of photographs.

Because of these variables, we use surgical simulation software (Crisalix) in the office to simulate the effects of different styles, sizes, manufacturers, and even positions of the implants, which helps take a lot of guesswork out. This is typically combined with the use of a sizing kit designed by the implant manufacturer. The kit has a variety of inserts that the patient can put into her bra or into a tight fitting top to simulate the effect of augmentation with various-sized implants. When combined with simulation software, this helps us agree on implant size, style, manufacturer, and other variables. We rarely have to revise our own breast augmentation patients for size as a result of this careful planning. However, we are often called on to perform revision breast augmentation on patients who had surgery elsewhere.

Published on Jul 11, 2012

The best place to start is by scheduling a face-to-face consultation with a board-certified plastic surgeon who specializes in breast procedures. It is too hard to give you sound advice based on the information you provided.

Determining the best size for you is not only based on your body type/shape and current breast size, but also more about what your goals are with the surgery. Some women workout a lot and don't want their new breasts to be a nuisance, so they choose a more conservative size. Other women want that "wow" factor with large noticeable breasts.

I have created a couple of useful features for patients to help them gain a better idea about the look they want. Take a look at the sections on this page called "The Look I Have and Design Your Look." I hope this helps. https://breastlift.com/breast-sculpting-overview/

Published on Jul 11, 2012

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. A higher profile implant will impart more volume and greater projection (less subtlety) for a given BWD. I will typically reserve higher profile implants for my narrow framed/thin patients.

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

Published on Jul 11, 2012