Size Matters

Size Issues

Whoever said size isn’t important has never dealt with breast implants. One thing I know for sure, after 15 years and thousands of breast implants, is that size does matter. It matters a lot. If you don’t get the size right, you probably won’t be too happy with the outcome of the procedure. In fact, I advocate that women who choose to have breast augmentation choose the best size implant and then work every other decision around that decision.

This is not to say that bigger is better. In fact it is not. The important thing about breast implant size is to select the best size for each woman. This is where things can get a little tricky, because women are all so different in where they start and where they want to go with breast size. For example, I could have 10 women walk into my office who have identical bodies, and each could choose a different size breast implant, and each could be happy with her selection. This is because a single size is not necessarily appropriate for a given body or breast size. Each plan must be individualized to that woman’s personal goals of how big she chooses to be, taking into account where she begins.

In order to find the size that is best for any given woman, I recommend the following steps:

1. Use silicone sizers. Even if you want saline implants, silicone sizers are the best. I used to recommend rice in baggies, but it just does not conform to the breast the same way. When using sizers, wear a tight-fitting sports bra (preferably 2 tight sports bras). The reason for the tight sports bras is because anything else will allow the sizers to appear larger than they actually are. Hence, a woman wearing looser bras or a cupped bra is very likely to select a size that is smaller than the size she truly desires.

2. Wear several different tops with your breast implant sizers in place to see how you look. Keep in mind that tighter clothes will always make you appear larger, and loose clothes will always make you appear smaller – no matter what size you select.

3. You may end up liking several different sizes. This is common. I recommend that you select the largest of all implant sizes that you like, stopping just short of the first one that is too big. This is soooo important. Here’s why: most of my patients are sitting on a fence with implant size. They want to go large enough so as to make the operation worthwhile, but they do not want to go so large that others notice or that they feel uncomfortable or that they are disproportionate. My strongest recommendation for women who wish to strike this balance is for them to select that very largest size that they like – but not one that is too big. Ever since I began advocating this approach, my rate of revision for change in size has dropped well below 1%, whereas the national average for revisions for change in size is between 10-20%. Of the few patients of mine who have chosen to undergo breast implant revision for change in size, half have chosen a larger size, and half have chosen a smaller size.

4. When you are viewing yourself in the mirror with sizers in place, be aware of the constraints of an established self-image which you might need to overcome. This is especially true for women in their 40s, 50s, and 60s who have become accustomed to looking at their modest sized breasts for decades, but it can also be true for younger women. I recommend that when you view yourself with sizers, you try to imagine that you are looking at the body of another woman rather than yourself. This helps make the decision-making process slightly more objective.

5. Bring your husband, boyfriend, sister, neighbor, cat, etc to help and offer their opinions and support, but be careful to avoid putting the size decision on them. This is especially true of boyfriends and husbands who may feel that if they help you decide, they will be to blame if you do not like the final size. So, my advice is that you should bring them along, but do not press them to give you input if they are hesitant to do so.

6. Ask your plastic surgeon to help you correlate breast diameter with implant size if you wish to be proportionate…but be careful with this, as there are many pitfalls with this approach. This may be the topic for an entire blog of its own.

7. Try to avoid using your desired cup size as a way to select implant size, as cup size is not standardized. The main place that cup size is relevant is with regard to selection of implant profile, but again, that is based on other factors as well…perhaps the topic for yet another blog.

8. If your plastic surgeon does not use sizers or if your plastic surgeon tells you that he or she will select your size, be wary. Most plastic surgeons will choose sizes that most women would be pleased with, but this does not help women who fall outside of the bell curve in their desires to be either larger or smaller than “most” women. Also, some plastic surgeons impose on other women their own perceptions of ideal breast size, which can sometimes be alarmingly large or disappointingly small.

Now, having asserted that size is the most important decision in breast augmentation surgery with regard to satisfaction, here are a few caveats:

* Please do not torture yourself over 30cc. For example, if you like the 360cc implant, you will like the 330cc implant as well as the 390cc implant. If you end up deciding that the 360cc implant was too small, then the 390cc implant would have been too small also. If you end up deciding that the 360cc implant was too big, then the 330cc implant would have been too big, also. Thirty cc is a relatively negligible amount, equivalent to 2 tablespoons. So, once you have decided on your implant size (or range), know that in order to change size in any visible way, you should change by at least 100 cc to be able to see the difference. (By the way, cc=cubic centimeter and ml=milliliter. One cc is the exact same as one ml).

* I view each woman as having a range of sizes that will all work well for her and will give equally satisfying results. So when I say that we need to get the size right, I am talking about a range rather than a specific size. That range may be 50-100 cc in either direction of the size selected – even taking into account that the woman selected the largest size that she liked among all sizers.

* Just getting the size right does not guarantee satisfaction, as other issues exist as well. See the rest of this site for details of all of the other factors that play a role in breast augmentation results.

Click here to see Breast Augmentation Before and After Images

Breast Wishes!
Jean M. Loftus, MD

PS: sorry for the corny sign-off, but I just couldn’t help myself!

235 thoughts on “Size Matters

  1. Size has been my biggest decision throughout this whole experience. Having small breasts I came in choosing the largest size implant and even asked if there were bigger. They looked great, but I did have concerns of being too big. I tried the sizers on three separate visits, but the 3rd time I brought 10 different shirts of all styles. This is definitely a great suggestion by Dr. Loftus. I did choose to reduce the size by 100cc, but feel very comfortable in my decision and I am so glad I brought all of those shirts!

  2. I have often wondered how size was determined in choosing breast implants. You have covered points that they just do not share on TV. I was always under the impression that it was by cup size and I stand corrected. Now I know there are many other factors involved in the process. Finding this information has increased my understanding and I feel more confident in my decision to have breast augmentation and deciding the best breast size for me.

  3. My wife had breast augmentation surgery approx. 16 years ago and wants to have it redone. I may get this for her as a gift but I have a few questions. She currently has 300cc implants and wants to increase in size to 425cc. Would this size change be an issue? Also, she has round (saline) implants now but when we look on websites, etc. we both like the look of high profile implants better. Is it okay to change from one implant type to another?

    Thanks, Derf (you said an alias was ok)

    P.S. We are actully in the middle of moving to Cincinnati so we may schedule an appointment to come see you. I thought your website was by far the best organized and offered the most helpful info of any I’ve looked at doing research (it really was research).

    • In general, it is possible to “upgrade” to a larger size. You can also change to a different profile implant. However, you must first consider the tissue thickness of the individual’s breasts to determine if a larger size is a good idea or not. This is something we can only determine from an exam during a consultation. Welcome to Cincinnati!

  4. Thank you so very much for all of your tips. I want breast surgery so bad. I have been small breasted my whole life. I also have had two children, one of whom I nursed. I have to wait until I complete my degree, kind of like my own selfless reward, but I feel the more I learn about the operation, the closer I am to finally having a dream come true. Thank you again I appreciate ALL of your tips, even the corny stuff!

    F.R. in Brandenburg KY!

  5. Hello…I am 29 yrs old and since I can remember, even before my children, my breasts have always sagged. My high school and collage years were really stressful because of my insecurity with my breasts..I hated going to water outings with my friends and others only because I felt restricted to the type of bathing suit I could wear…I wanted to be able to grab any swim suit and be comfortable in it, but I couldn’t because my breasts sag…I’m really considering a breast lift……and this site was helpful with my decision…

  6. I sure wish I had read this blog before I had the surgery with another doctor…and wish I had come to Cincinnati for my aug to see Dr. Vennemeyer and Dr. Loftus!. I am paying for it now.

  7. I recently got my breast augmentation and went from a small B to a full C. My self esteem has not been better. I went with the saline implants under the chest muscle when I got my breast augmentation. After 6 months my breasts looked and felt just as natural as ever. I would highly recommend anybody thinking about getting a breast augmentation.

  8. Concerned about selecting the correct size. I have gone to three different consultations until I found your very informative website. The first one started me off at 300cc and the second at 400cc, which I thought, was huge for my figure and what I’m trying to accomplish. The website helped me answer a lot of questions and put some of my nerves at rest after watching your videos.

  9. I had my BA by Dr. Loftus in April 2010. It was the best decision I ever made regarding my body. Dr. Loftus was the greatest. Very imformative and helpful. Her staff was outstanding. I went with 397cc silicone moderate profile. I am 5’10” 155lbs very atheltic build. I was afraid that they were too big because I didn’t want anyone to notice. I wanted my breast to fill out what skin I had after three children. They were swollen for a few weeks but then dropped and they look wonderful!!! After 3 months I still catch my reflection and smile. If you can get to Cincinnati or KY, go to The Loftus group – get there quick and trust in the staff!
    Absolutely thrilled in Cincy!

  10. Jess,

    Dr. Loftus and Vennemeyer’s office has a great technique to help you decide. Trust yourself with what feels comfortable when you are trying on the different sizers. DO NOT decided on cc’s of the implant, try them first.

  11. This is a great Blog. I was not sure how to decide, but Dr. Loftus really helped me figure out how to pick a size that was right for me- She’s the best.

  12. Dr. Loftus has some great recommendations to finding the perfect size for your breast augmentation. I find it very interesting that she suggests to avoid using your desired cup sizes as a way to select implant size because a cup size is not standardized. This is such a huge change to one’s body that I could only imagine how hard it is to make a decision on the size. I have always wanted a breast augmentation and when the time is right I will be visiting Dr. Loftus and taking all her recommendations into consideration. Size does matter and I want to make sure that I make the right decision, because I do not want to be one of those people who are unhappy with their procedure because I did not choose the right size

  13. GReat site. Very helpful. I am seriously considering traveling to Cincinnati to have you fix my breast implants (placed by a doctor in Texas).

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