Breast Implant Size

How do I select the appropriate breast implant size?

This is a decision you and your surgeon will make together. It is important to understand that there is not a wide range of implant sizes and profiles that will look natural in each individual patient. Given your height, weight and preoperative breast profile, there really is a limited range of implants sizes and profiles that will produce a full - but natural - breast appearance. So it is important to establish from the beginning whether or not you and the surgeon that you have selected have the same aesthetic vision. One of the best ways to do this is by reviewing the surgeon's 'before and after' photos.

You can certainly purchase the size bra (unpadded) that you would like to fill out and experiment at home with bags of rice. One implant manufacturer also has a 'pre-consultation' kit with sample 'sizers' that you can use at home to get some idea of the implant size range that may work best for you. You could bring some photos to the consultation appointment of breasts that are appealing to you, and you can show your surgeon which of their 'before and after' photos are most appealing to you. There is no substitute, however, for the process of examining different implant sizes and profiles with your surgeon during your physician consultation appointment. You can hold them up in front of your breasts, and you can put them in an unpadded bra that is the size you would like to be. Your surgeon can show you how each implant's base diameter and projection will impact breast appearance. This will give you a very good idea of the result you are likely to get from each size and style.

Implant 'profile' refers to how wide an implant is (base diameter) compared to how much forward projection it has (height). The implant manufacturers use different terms to describe these profiles, but in essence there are three types: low profile (wide base diameter / modest projection), intermediate profile (less wide, more projecting) and high profile (even narrower diameter, very projecting). If the goal is a full but natural-appearing breast enhancement, almost all patients need a low- or intermediate-profile implant. A 'deflated' appearing breast with little forward projection usually looks best with a intermediate profile implant, while a more youthful-appearing breast with some natural, inherent projection often looks best with a low profile implant - especially in a slender patient with an athletic frame. There are very few patients that need a high profile implant, at least not if the goal of surgery is a natural-appearing breast enhancement. The combination of narrow base diameter and high projection is really an implant style that is more suited to breast reconstruction than breast augmentation.

Ultimately, you will have to put your faith and trust in the surgeon you have selected. Communication is key, so be certain that you and your surgeon have the same idea of what a beautiful breast looks like. And make sure that your surgeon takes the time and effort in the operating room to use sterile breast implant 'sizers' to determine the implant size and profile that is ideal for you personally. A good breast augmentation surgeon goes into the O.R. with a good idea of what implant size and profile will work best for a patient, but makes the final decision using implant sizers. Breasts are often asymmetrical in size and shape, and the chest wall may also be asymmetrical in terms of its forward projection on each side, so in some cases a surgeon may need to use implants of different size and/or projection. The only way for a plastic surgeon to ensure that a breast augmentation result is full but natural-appearing, and as close to symmetrical as possible, is to evaluate the appearance of a variety of sizers in the operating room with the OR table raised into an upright, sitting position. Your surgeon should keep a full inventory of implant sizes and profiles in the surgery center, so that the implant choice is never limited by 'what is available'.