I want to get breast augmentation. What size implants should I go with?
This is a question we see very frequently by our patients. Breast augmentation is one of the most commonly performed cosmetic surgical procedures every year in the United States. Often times women have been considering the procedure for many years and patients are typically very happy with their results. For many patients, one of the most intimidating parts of the decision process is selecting volume of implant they want. This can cause them to delay or even avoid the procedure altogether because they are so concerned about by selecting the ‘correct’ implant size. Fortunately, there are many different ways to work through this decision—together with your surgeon—so that you can arrive at a comfortable decision that leaves you feeling confident in your decision of implant size.
Usually, one of the first subjects to come up is brassier cup size. While this may provide some insight to goals and is an ok starting point for the discussion, it unfortunately lacks clarity. As most women know, brassier cup size varies among different brands. For example, a patient may have one bra size at Victoria’s Secret, but will a different cup size at Nordstrom. This is the same reason we typically do not guarantee specific cup sizes after surgery.
One very helpful way of clearly communicating goals is for patients to bring photos of examples of the type of breasts (ie: shape and size) they are desiring. This knowledge not only helps determine what size implant we may want to look at, but also tailor other surgical details if needed to help achieve the desired look. This may include implant positioning (ie above or below the muscle or implant material (ie saline vs silicone vs super gummy silicone, etc). For example, if a patient wants very natural appearing breasts, we may use a softer silicone material (ie less gummy) with a little less projection and place the implant under the muscle, whereas a patient who wants a very busty shape with exaggerated cleavage, we may consider using a more firm silicone with higher projected shape. So, this method is very helpful for the surgeon especially.
While photos are very helpful for the surgeon to understand what the patient desires, I find that patients tend to like the Vectra imaging system and silicone sizers best, and it seems to me that patients seem to gain a lot more confidence in choosing size after going through these two modalities. The Vectra imaging system allows the surgeon to upload specialized three-dimensional photos of the patient. The system then analyzes and characterizes the breast and chest wall anatomy, and is able to simulate how different size breast implants will look for your body.
Silicone sizers, on the other hand, are silicone ‘implants’ that are designed to sit on top of your existing breast. The sizers have volumes corresponding to implants. They can be placed under a sports bra, bathing suit, or other clothing to simulate what implant volumes may look—and to some degree, feel—like. Patients can see what they look like in the mirror with that size of implant.
In nearly all cases, after going through this process, patients are much more confident in selecting a size of implant that they like, and some of the initial anxiety or reluctance changes to excitement.