How is implant size selected?
Implant sizes range from about 100 to 500 ccs. Breast size increases approximately one cup size for each 200 cc added. A natural appearance is one of the most important goals in breast augmentation. The larger the size the more difficult this is to achieve. Implants that range between 200 to 350 cc will typically yield an aesthetically pleasing result. As the volumes increase so does the diameter of the implants. At a certain point overall aesthetics are negatively impacted by implants that not only project too much but are also too wide and full on the sides and top.
Size selection is guided by a woman’s wishes but is also influenced by height, chest size, and the amount of breast tissue present. Some of the important limiting factors in size selection include skin quality, tissue quality, nipple position, and the general shape of the breast: small breast base diameters and tight creases under the breast being particularly limiting.
Magazine photographs, cup sizes, and the experiences of friends are not reliable determinants in size selection. Photographic results cannot be measured or standardized and bra cup sizes vary widely from one manufacturer to another. Friends have different breast shapes and starting volumes as well as different physical proportions and aesthetic senses.
The most practical method to simulate the effects of different size implants is to try on various sizes in a larger bra (Figure 13 – legend: Sample implants of various sizes are used for the sizing process). This is done during a separate appointment that focuses exclusively on this issue. Final size selection is done in collaboration with the surgeon and takes into account physical factors that may argue for either a larger or smaller choice. Typically, one size larger than that selected during the sizing process is used during surgery to compensate for the amount of padding present in the sizing bra (Figure 14 – legend: A patient is shown before surgery (top left), with a 300 cc sizing implant in a 34C bra (top center), and with tank top over it (top, right). She is shown again after placement of a 325 cc implant (bottom left), with the same size bra on (bottom, center), and with a tank top over it (bottom right). Note that the breasts look higher with the implants in place compared to the sizing views). Sometimes, conditions during surgery warrant a slightly different size based on the actual appearance of the preselected size and the surgeon’s aesthetic judgment.