It is an all too common expression during the initial breast augmentation consultation. It’s that “I’m pretty sure I want to have this done but I’m nervous as hell about picking the right breast implant size” look. Patients tell me about a particular size implant a friend had. They mention that they want to be just one or two cup sizes bigger. They want to be bigger but not too big. They want to look “natural” but want more cleavage.

So how do we go about the process of picking the right breast implant size? The trick is finding that point where the patient’s goal intersects with her natural anatomy.

DEFINE THE GOAL: CUP SIZES

Cup sizes are not standardized between manufacturers. Furthermore, it’s a crapshoot to match an implant size with a cup size. A 250cc implant on one frame might increase a patient by one cup size while the same implant might increase another patient by two cup sizes.

By the same logic, just because a friend of yours had a 300cc implant and had a particular result does not mean you would have the same result with the same implant. Brass tacks: don’t think about cup sizes or cc’s but rather focus on the look you want.

To that end, I ask patients to show me photos of an ideal result. They can pick from my gallery of patients or they can do their own web searches. These goal photos are a crucial first step in communicating goals. A picture indeed says a thousand words.

PHYSICAL EXAM

I take a series of measurements to understand each patient’s anatomy. Evaluation includes width of the breast, distance between the nipple and the fold, areolar width, skin elasticity, and skin thickness among others. A detail-oriented understanding of each patient’s anatomy is a critical part of the process.

By accurately defining the footprint, I can personalize the implant selection and ensure we are not violating the patient’s specific anatomic boundaries and the goal size is accomplishable.

BRA SIZERS AND 3D IMAGING

This is the part of consultation where patients really start to enjoy the process. Specially-made bra sizers are designed to give a patient a reasonable estimate of what specific implant sizes will look like. Knowing the patient’s general goal from our discussion and goal photos, I have a good idea of a volume where we can start.

The sizers are placed underneath a special pad-less bra and patients are given time to look in the mirror with or without a shirt on over the bra. They can try bigger or smaller depending on their preference. Once we narrow down a volume, we can use 3D imaging technology to produce a postoperative rendering of what an implant would like on the patient’s body.

At this point in the consultation, between the goal photos, bra sizers, and 3D imaging, we have effectively narrowed
down the volume to a narrow range.

TRUST THE PROCESS AND RELAX

It is something of a journey moving from an idea of a look to a specific plan for the operating room. However, the techniques that I use not only help a patient define the look they want but also empower them to be an active member in the decision-making process. In this way, on the day of surgery much of the anxiety patients might have felt in the beginning is replaced with peace of mind, confidence, and excitement. If you would like to learn more about breast augmentation, call the office today to schedule a consultation!