One of the most important considerations, if not the main one, that most women ponder when undergoing breast augmentation is what size they want to be. How big of an implant should one get? Much thought goes into the size of the breast implant from both the patient and the plastic surgeon. There is no exact science in making an implant size choice and this is reflected in the many methods that are used to help this decision process.
Considering a woman’s breast base diameter measurement compared to that of an implant’s is the simplest and most measureable method that we have. While this will ensure that a breast implant will never be too large (exceed the natural breast base width), there are other breast tissue considerations that this measurement does not take into account. How much natural breast tissue one has and the amount of breast skin and its elasticity will also play an important role in the outcome of the breast augmentation result.
Plastic surgeons think about quantifiable elements of breast augmentation such as implant volume and base diameters and projections. Women think mainly in about cup size, which while being a measure of breast volume, is hard to accurately define. In the end, however, there is only one issue that matters…how does the breast look.
In that context, I find it helpful in my Indianapolis breast augmentation patients to have them tell me what ‘look’ they want. Not cup size but an overall final breast look that they are after. This does somewhat relate to the nebulous concept of cup size but women can think better if it somehow relates to what they are familiar with. I ask patients to review these descriptions and select the one that best describes what breast augmentation look they want.
A ‘small’ breast augmentation is when only the lower pole of the breast becomes fuller. There is little to no change in the upper pole of the breast. The upper pole only becomes a little fuller when there is little to no breast tissue prior to surgery. If one has some pre-existing breast tissue, which exists only in the lower pole, the breast becomes modestly bigger but its shape does not change. Many women would call this type of breast augmentation result a full ‘B’ cup.
A ‘medium’ breast augmentation is when some change in the upper pole of the breast occurs as well as the lower pole. But the upper pole fullness is not significant enough that it looks round or unnatural. It does not appear that one has breast implants. There is a change in the size of the breast and some alteration of its overall shape, but the breast does not look round or surgically altered. Women will often call this a small to medium ‘C’ cup.
A ‘large’ breast augmentation is when there is a very noticeable change in the entire breast mound. The upper pole is just about as full as the lower pole and the breast acquires more of a round shape. The inner pole near the sternum and the outer pole toward the armpit will now have greater roundness as well. It will be more obvious that one has breast implants but the breast implant does not exceed one’s natural breast base diameter. This is often called a full ‘C’ cup or a small ‘D’ cup.
An ‘extra large’ breast augmentation result is when the entire breast mound in all poles becomes expanded. The breast will look very large and round and assume a more spherical shape. The implant will have exceeded the base diameter of the breast and it will be very obvious that one has had a breast augmentation. This would be referred to as a full or double ‘D’ cup result.
While no method of breast implant size selection is perfect, knowing what final breast look a woman wants is very helpful. There is always a range of implant sizes that can achieve these type of breast augmentation outcomes.
Dr. Barry Eppley
Indianapolis, Indiana