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You’ve decided to better fill out swimsuit tops, to restore your nursing breasts, to better proportion with your lower body, or for another reason to enlarge your breasts. Usually, it is a good decision. You have plenty of company. Breast augmentation is a common procedure that changes lives for the better. Women consistently report satisfaction rates well over 90%. Although implants remain imperfect mechanical devices, technology is improving. Breast implants marketed today are the safest most durable devices ever. Manufacturers offer limited warranties against contracture and rupture, historically two of the reasons women most often need secondary breast implant related surgery.
How should you choose the breast implant size for your best breast augmentation result? Our time-tested approach has proven successful for many and applies to women in almost every situation. Many focus primarily on the three dimensional volume (cc’s = cubic centimenters) of implants. However volume depends on the most important two dimensional and easy to understand metrics: Base width and implant projection (profile).
Measure breast base width.
Base width extends from inner to outer edge of the breast. If right and left breasts are symmetric (about the same measurements and appearance), base width is equal on both sides. Implant width should roughly match breast base width, adjusted down a bit for skin thickness. Base width is the most important fundamental measure. If the center of a round implant is directly behind the nipple as it should be, edges of the implant should extend to edges of the breast. Base width matched implants produce aesthetic circumferential breast fullness. A narrower implant leaves too much space in the center of the chest between breasts. Implants that are wider than breast base width hangs off on the sides and may cross the midline (“uni-boob”). Base width is not a measurement you or your surgeon chooses. Base width is measured on your chest, and does not change regardless of the implant projection. Projection is the same as profile, and this is a measurement you DO choose.
Evaluate current breast size.
The smaller you are to start, the higher profile needed for your desired result. The larger you are to start, the less profile and volume needed for your desired breast size. If you are A cup, a larger implant is needed to become a full C cup. If you are B cup, a smaller implant will get you to full C.
Evaluate desired breast size.
Your plastic surgeon must understand the proportion and shape you want. Final cup size is one way to explain an approximate appearance, although actual bra cup size varies with the make and style of bra. Some patients show photos of breasts they like on other women to communicate the breasts they want. In our office, women try base width matched implants of different profiles beneath a sports bra. Seeing your silhouette in mirrors from different angles with several implant projections resolves uncertainties and helps finalize preferred breast implant size. 3D photo simulation with software insertion of chosen implants shows the result after breast augmentation with those implants. Uncertainties may also be resolved by 3D simulation with several sizes for comparison.
Evaluate skin compliance (elasticity)
Skin must be sufficiently loose and elastic to accommodate selected breast implants. Breast skin is naturally soft and expandable, but large implants are difficult to insert beneath a tight skin cover. Implants too large for the breast skin envelope appear less natural over the long run. Breast skin after one or more pregnancies is usually more easily stretched for implants.
You should choose your breast implant size, not your plastic surgeon.
Other factors affecting breast augmentation outcome are orientation of ribs and chest, sagging nipples and skin that may be an indication for breast lift, elliptical breast shape, eccentric nipple position, asymmetric or conical breasts, and others.
Breast implants become a feature of your body in every situation for a long time. Women should choose their own implant size, not plastic surgeons. Your doctor should supply enough useful information for you to confidently select the best breast implant size for years of comfort and enjoyment.
