How to Pick your Desired Breast Implant Size
One of the single greatest concerns for most breast augmentation patients is…..getting the amount of breast size increase that they desire. While most fears revolve around a concern that they might be too big, others are concerned that they get enough breast size increase to ‘get their monies worth’. Either way, besides the type of breast implant that they choose (saline vs silicone), patients are ultimately concerned about achieving the main objective of the operation – bigger breasts.
While there are many different methods used by plastic surgeons to pick the size of breast implant, and in experienced hands they all work, I will describe my approach to it. First and foremost, I don’t particularly care what size a breast augmentation patient wants to be. The patient is not doing the operation for my tastes and desires, my only goal is to make the patient happy. The patient has to decide what breast size that is, not me. My job is to understand what that is and translate that understanding to the proper breast implant size selection at the time of surgery.
To achieve that understanding, I ask that the patient bring in some pictures of breasts that they like. Pay no attention to the person to which they are attached (big, tall, thin, or small), as it does not matter. What matters is the look of the breast and the mound size. Pictures that also illustrate too big or too small is also helpful. These pictures are important as they will be put up in the operating room during surgery and used as a visual reference. Because I use intraoperative sizers (temporary implants that are initially placed and then blow up with air), I can inflate the breasts until they match the size seen in the pictures. (it is not hard to do!) Then and only then are the permament breast implants pulled. This method doesn’t have an actual name but I call it the intraoperative sizing method.
When it comes to breast implant size, I think the only important anatomic concept for the patient to grasp is breast base width. If the size of the breast implant chosen is wider than the base of your natural breast, then a portion of the breast implant will hang out beyond the side of your chest wall. (and may get in the way when you swing your arm) That measurement is taken before surgery and recorded. The patient needs to let me know before surgery as to what is most important, ultimate size or keeping the breast implant from being too far to the side if the breast implant is larger. (most of the time this is only as issue when it comes to larger breast implants or in very petite women with narrow chest widths)
I have found this intraoperative sizing method to be highly successful. I have only had one patient in my entire practice career that has ever requested to return to surgery because she felt the implants were too big.
Dr Barry Eppley
Indianapolis, Indiana