When recently answering a question from RealSelf, I was really surprised by how the patient did not have a good understanding of the anticipated breast size she was about to get. She, after a breast augmentation consultation with a cosmetic surgeon, was getting breast surgery with silicone implants. She stated she was 36 B and wondered what size she would be postoperatively after placement of a particular implant size. I recommended that she needed to discuss this with her plastic surgeon further before surgery.

In a breast augmentation consultation, the surgeon and the patient have a chance to get to know each other. The surgeon must make sure the patient’s health condition allows the surgery to be performed safely. Assuming that the breast contour is such that no additional procedures, such as mastopexy, are necessary, he/she needs to figure out the appropriate breast implant size.

Some patients come to the consultation with a particular breast implant size in mind, such as full C cup or mid D size. This helps me narrow down somewhat the range of sizes they are interested in.  However, just because someone has a certain cup size in mind, does not mean I, as the surgeon, envision the same volume as the patient. Furthermore, some people request a specific number of cc’s (for example, 350 cc high profile). When I ask how they arrived at that requested volume, often they respond “that’s what my friend got and I like the size” or “I saw a picture and that girl had that size implants.”

Keep in mind that no two people are the same. Just because your friend got a particular size implant you like, does not mean that size will look the same on you. The starting breast size, the circumference of chest, the thickness of subcutaneous fat, the shape of rib cage and other various factors can influence the size of the recommended implants.

There are many different ways to help the patients decide on the right implant size, such as rice bags, computer simulations, and so on. I have been using the silicone sizers by Mentor for many years. This allows the patient to wear the sizer and more precisely see and feel the anticipated breast sizes. I have surveyed many of my patients after surgery to find out how the recommended sizes and the actual sizes compare. The results showed excellent correlation.

The take home message is that you should have thorough understanding of the procedure, the risks and benefits, and the size you can expect to get before breast augmentation. This is also true with any other surgery as well.