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6 Factors that help decide on a breast implant size?

A cup B cup C cup or D cup

Choosing a breast implant size is one of the most difficult decisions a patient has to make when deciding to have a breast augmentation.  For the most part, most women only know that they want to be bigger; but don’t necessarily know what that means or how they will look.  This series of pages will highlight some of the questions you might want to ask yourself or your plastic surgeon when making your choice for a breast augmentation

The ideal breast size on paper might not be the ideal breast size for you or your frame.  While many patients will come in starting with A cup breasts, others might come in with C or even D cup breasts and want to be either larger or fuller.  

The first step to choosing a breast size is simply knowing is accurately knowing what size you are now and what size you think you want to be.  I have two suggestions.

Try on Bras at Victoria Secret before your visit.

  • For consistency, I like my patients to use Victoria Secret bras to test breast and bra sizes.  Nordstrom sizes, for example are often 1 or even 2 sizes larger for what is reported as the same bra size.  
  • Wear a dress that you like and that is flattering.
  • Find a bra that fits you will now and that is obviously your starting point.  
  • Then find a bra that is 1,2, and 3 sizes larger.  Fill the bras and that will give you a first clue of what size you might be happy with.  

Find and bring a breast model that has a similar frame that you might like to emulate.

  • Although less accurate, many patients will bring in pictures that they might want to emulate.  The major problem with this method is that sizes are not often reported accurately… depending on where they buy their bras.

*See later pages to learn how the procedure is performed

The ideal breast size is very subjective and will often depend on your body frame.  The most requested size is a C cup.  But depending on your body frame, a C cup might be either too small or too large.  

Patients will often underestimate the importance of their daily activities when they consider breast augmentation.  Both the size and weight of breast implants might help or hinder a patients exercise routine for example.  Patients who exercise and run a lot might want to consider more moderate sizes.  

Even C-cup breasts don’t appear to hinder activities in women with small frames and strenuous exercise routines.  

Visia 3D imaging has been extremely helpful for our patients choosing the right breast implant size.  While it is still very helpful for a patient to consider all the issues that are addressed in this list, Visia 3D imaging allows you to see yourself as if you already had your breast enlargement surgery.  

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An unfortunate part of life is that everything begins to fall with age, time, and pregnancies. Breast will begin to droop.  Even the nipples will often elongate and droop.  Choosing a breast implant for young women who have not had children is very different than choosing a breast implant for women that have had children.  

Women who have had children will in general have some breast droop and upper breast deflation given that their breasts were stretched with pregnancy, milk, and breast-feeding . 

Very often, their primary goals are not necessarily to be larger, but simply do fill out the volume loss in the upper breast and perhaps lift their breast and nipple position a little.  

Patients with just a little volume loss and breast droop will be able to compensate from a smaller do moderate sized implant of their choice.

Patients with significant volume loss or breast droop will most likely need a larger implant that might not be appropriate for their lifestyle, appearance, or activity levels than they would like.  They might benefit from a small breast implant and a surgical breast lift instead.

The general rule of thumb is if your nipple position is below the bottom margin of your breast or if the nipple position and breast are more than 1-2 centimeters below your inframammary crease, you will benefit from a surgical breast lift.  

The problem is that if you only have a breast augmentation without a lift, the breast implant sits high while the breast still hangs low along with the nipple position.  

As mentioned above, some women with only a little bit of breast droop can compensate with a larger implant.  This strategy is limited however in that the implant might need to be larger than what might be appropriate for your frame or physical activities.

Bra sizes at Victoria Secret are very different from buying bras as Nordstroms and very different from buying bras at a boutique bra fitters.  For simplicity and consistency, I usually express my views on breast size based on Victoria secrets as it is a common brand to most of my patients.  A C cup bra at Victoria Secrets is usually a D cup bra at Nordstroms and a DD+ bra at a professional bra fitters.

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