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How Do I Choose my Breast Implant Size?

At OC Breast Surgery we help our patients to choose the breast implant size that is best for them. It starts with educating patients about breast size. Most people are accustomed to thinking about breast size in terms of a letter: A, B, C, full C, D, etc. but this system is fraught with confusion as a cup size is proportional to the chest circumference generally measured in even numbers: 32, 34, 36, etc. Therefore, a 34C cup is bigger in volume than a 32C cup. Another way to view this is that a 34C cup is about the same volume as a 32D cup. To top this off, 50% of the women in the world are ideally fitted into odd number bras that don’t generally exist: 31. 33, 35, etc. So… we are not trying to get a woman to a particular lettered cup size but to help her figure out what the balance or proportion of breast to body she might desire. 

We have a general and specific way to accomplish this prior to your second visit to our office which will be the preop visit with our staff (your first visit is obviously the consult with the OC Breast Surgeon). The “general” method involves you choosing four naked breast photos from our website (or any) in which you like the balance of breast and body for yourself. It is important to pick photos in which you already like the woman’s shape so that your attention can be focused on volume. Please do not concern yourself with whatever the caption might read in terms of their implant size or what cup size they think they are, as the overall size of the breast is comprised of breast tissue, fat and implant…and every chest circumference throws in another variable. Please also bring in four similar photos in which the size of the woman’s breasts relative to their body is too big for what you want. 

The “specific” way to help you focus in on how big you might want to go is to actually try on different volumes and see how it looks and feels to you. This is accomplished by buying a few different sized bras (no padding, no push-up) and then stuffing them with flax seed placed in a cutoff nylon stocking with a twist-tie. The nylon stocking allows the filler to distribute evenly across the entire breast. Fill the stocking and bra until you think you like it and then PROVE to yourself what is too big. Don’t assume you know. Go bigger until you have a bit of a laugh and then bring it back down to where you think you might like it. Consider how you might think about the size six months after surgery when you have had that time to get accustomed to this new volume. Once you have an idea of the volume that you like, you can then pour the flax seed into a measuring cup and read off the number of milliliters (1 ml = 1cc) and implant companies refer to their implant volumes in terms of the cc metric. After you have completed this, you will have your first good idea of how big you might want to be and what actual volume of implant gets you there.  

This breast sizing can be informative and fun but challenging. Do not worry about it too much as our staff will also do similar sizing with you with some tapered gel sizers during your preop visit. So, you will need to bring in the bra which you would like to fill. By the end of this visit, you and our staff will have decided on a range of breast implant volumes with which you are comfortable and an idea of how much bigger one breast might be versus the other. It is good to know that implants generally come in about 22 different sizes from ~150cc-800cc. In the lower 2/3rds of this range the difference between one implant size and the next is about two tablespoons (30cc=30ml). Two tablespoons are a relatively minor change when one considers the volume of the overall breast. 

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On the day of your surgery, our OC Breast Surgeon will review all your information, your photos, your sizing, your lifestyle needs, etc. Skin markings will be placed and once everything has been discussed and understood, you will be taken into the operating room and be drifted off to sleep by the anesthesiologist. We will position your arms to the sides of your body but in an ergonomic position with your hands overlapping one another. This allows us to comfortably and safely sit your back up with the OR table as many time as needed to visualize the natural contours of your breasts during augmentation surgery. This approach is preferable to putting arms on arm boards extending outward from the table as it allows one to simulate the breast in the normal upright position. Otherwise, to optimize your postop breast appearance, you will need to walk around with your arms extended outward.

Once asleep, the desired skin incision will be used through which an ideal submuscular space will be created. Various sizers will be tried within the size range agreed upon before surgery. We will sit you up multiple times throughout the case to adjust the volumes and shapes until we have achieved an optimal SM space, volume and shape, based on your preoperative desires. The pockets will be further prepared and injected circumferentially with Marcaine and Exparel. These two local anesthetics help to minimize postop pain along with meticulous surgery to minimally harm the sensitive tissues and minimize any bleeding/bruising. All sizers and implants are inserted throughout the case with the aid of a Keller funnel which minimizes contamination of the implants by the skin. Once the ideal volume is determined, we will open and insert your new implants. The incision is closed in layers with absorbable sutures. There are no external sutures or drains. You will only see a small tan piece of breathable tape over the incision. After about an hour in recovery, you will be discharged home.