Breast Implant Sizing - Q&A

Breast Implant Sizing - Q&A

Could you give an overview of what happens during a breast augmentation consultation - particularly in relation to addressing sizing questions?

During a breast augmentation consultation, I do a thorough history including pregnancies, breast feeding, plans of future pregnancy and breast feeding, personal or family history of breast cancer, last mammogram, etc.  Then a focused exam is done including several measurements that will help guide implant sizing.  Photographs are taken.  Finally, a thorough discussion is done with the patient regarding goals, expectations, risks & benefits which includes reviewing before & after photos as well as any photos the patient has brought of breasts they find “ideal”.

What advice do you give patients when it comes to deciding on the size of their breast implants? Are there any tried and tested methods to figure out the most flattering implant size for patients?

Once we’ve discussed the patient’s goals (for instance, to have their “pregnancy breasts back” or to look a certain way in their favorite top, etc.) I use this information to guide choice of size.  

There are many methods to choose an implant size.  Everything from the “rice test” to the “high five” measurement calculation to 3D modeling has been used to figure out the most flattering implant size.  I currently do sizing as a separate office visit where the patient brings a bra and top that they would like to “fill out” and we try inserting different volumes of sample breast implants until we are happy with the look we achieve.

The feel of breast tissue is important to lots of patients - are they able to hold implants of different sizes to feel their size and weight?

A breast augmentation consultation is not complete without the patient being able to observe, hold, and “squish” each style of implant that I use.  This helps guide the patient to a feel, shape, and texture that best achieves their goals.

Do you find patients have an ideal cup size in mind when they come to consult you? Does that expectation often evolve during consultations?

Patients often come in with an idea of what cup size they’d like to be.  This gives me an idea of their goals.  Each patient is measured during their consultation.  Interestingly, many patients are wearing the incorrect bra size to begin with.  Rather than cup size, I focus more on the look they want.  Most store-bought bras are not standardly sized and therefore cup size cannot be guaranteed.  I re-measure my patients after surgery so they are able to buy properly-fitting bras once they have healed.

In terms of different types of implants - do you have a preference between silicone and saline implants? If so, could you give a few words on why you prefer it?

There are pros and cons to each type of implant.  I discuss each with my patients and we arrive at a decision that works for them.  Silicone implants still trump saline in terms of “feel” in my opinion.  But it is the patient that ultimately decides which style will better achieve their goals.

Lauren Chmielewski, MD