How do you work out what size?

If a patient comes to you asking for a natural but bigger bust what factors do you have to take into consideration (weight, height, current size) when determining cc size? Do you find it easier if a person shows you a picture of how they want their breasts to look, or are you able to convert cup sizes to cc's (as a guesstimate)? Do you find there is a limit on how large a person can increase their breast size in their first augmentation?

This is like an exam question !!
I will give you my view and how I do it ....
Firstly I listen to what the patient wants - it might not be possible, or they might be confused - but its the best start point and 80%+ of the time is possible.
The smaller the back size of a bra, the less extra volume is needed per cup size increase. 30 inch back around 100cc per cup, 38 inch back around 150 + cc per cup - very roughly. You all know that cup size is variable anyway depending upon who measures you, how comfortable you want to be and which manufacturer you use!
For that reason I never promise a cup size, but work towards a volume / proportion / appearance goal. I do ask patients to use rice sizers at home to see how much extra volume they think that they want - dry rice in a stocking foot does very well - it also weighs about the same as an implant. I also like pictures of "Likes and dislikes" - whilst I can make anyone elses breasts the pictures show a trend that helps me to look at proportion and shape and therfore choose an appropriate size, projection, shape and position of implant. I generally also use a sizer at surgery to finally check that I have the best fit / compromise of size to appearance before I put in the definative implant. In this way I have found that I have very happy patients. It also allows me to let people know in advance if I can meet their expectations, and if not - why not. For example a 30 inch back AA cup wanting to look natural and DD or E is unlikely to happen, even with a submuscular teardrop implant - it just wont look that natural at that size - Best to have that sort of discussion before surgery so I know whats most important to the patient - ulimate size, or natural shape.
It is true that sometimes it isnt possible / safe or sensible to make too big a jump in size in one go. Generally however if a breast has been bigger when pregnant / feeding or if a patient has been heavier, then this size or even lager should be possible in one step.

Hope that sums it all up well.

JP

Thank you so much, I know it was a bit of a long one lol, but it's the question we get asked so much on here, so it will be so helpful to the pre BA girls.

I found that helpful but could you tell me how breast width diameter factors into this? The reason I ask is that I have a breast width diameter of 14cm and the implant I have is 11cm. It stops before the sides of my breasts and I am having a re-op to correct it and am having a wider implant put in. I read that for optimum effect an implant should be around 1cm less than your BWD. In your opinion is this is correct? I think my surgeon is proposing to use an implant with a width of 11.75cm in my re-op and I would hate to be disappointed again.

Thanks.

Base width, and height if using anatomical implants is an essential consideration too when considering what implant to use. I measure this and yes, deduct a centimeter if I am not trying to expand the breast base. Sometimes however the natural breast is too narrow on the chest wall - in which case I may release the breast more on its outside edge and use a wider base implant to broarden the breast on the chest. It may be that you want a broader or higher breast fullness - 7.5 mm is not likely to make a very significant effect if this is what you want to achieve so think very carefully about what you want your reoperation to achieve.

JP

Many thanks for your clear explanation it has been a great help.

Its a pleasure to be of help Peachy!

JP

Hi John,


I couldnt find where to start a new post to you. I would love your help.

I went for a consultation and was recommended i get 215cc high profile polyurethane teardrop implants to be placed partly under the muscle.

I am very petite 5"1, 28A, 6 stone. I want to look natural and in proportion but am worried they will also be too small. I want to achieve a 32C.

Could you please let me know your thoughts.

Thank you so much for your time.

Kindest Regards

Hi there
If you start a 28 you will end up a 28 or possibly a 30 but not a 32. Your chest size just won't change that much. With such a small chest size it doesnt take much volume to take you up each cup size so 215 to 260 cc would be my guess to take you to a full C - try the rice test and see how that feels . I find picures of a favourite target breast shape and proportion help me a lot too. Hope this helps!

Jp