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Breast Implants

If you’ve recently decided to undergo breast augmentation surgery, you’re probably feeling very excited about the changes you’re about to experience. But once you have committed to surgery, there’s another significant decision to make: what size implants should you get?

Ultimately, the breast implant size you choose should reflect your aesthetic goals and personal desires. Your decision must also factor in long-term considerations such as your health, comfort and the aging process. Improperly fitted breast implants produce poor results — diligently carrying out the breast implant sizing process prior to surgery will ensure you enjoy an excellent outcome.

The ideal implant size should meet your aesthetic wishes and allow you to live a healthy lifestyle, free of future complications. As a general rule, very large breast implants both look unnatural and can pose risks, causing problems such as back pain, tissue thinning around the breast or sagging (more on that topic below).

So, what factors should inform and guide this very personal choice? There are a range of crucial questions you should take into account and discuss with your surgeon before settling on implant size. Some key considerations include:

  • Do I want a natural look, a slightly augmented look, or an obviously augmented look?
  • How will my breast augmentation affect my lifestyle?
  • Will my breast augmentation affect my ability to carry out athletic activities like running?
  • How will my implants affect my bra and clothing choices, and how will I look in a bra and clothing?
  • How will my breast implants affect the health of my breasts?
  • Will my breast implants put me at higher risk of requiring mastopexy (breast lift surgery) later in life?
  • Will larger implants lead to back and shoulder pain or affect my posture?
  • Will the size I select now still be appropriate in another ten to twenty years?

Consultations with a board-certified plastic surgeon will help you make the right choice and ensure you get the results you deserve and desire. Properly fitted breast implants that are proportional and balanced for your height and body type are essential for a satisfying outcome.

Below are some key considerations to assist you in making this important decision.

Breast Augmentation Surgery

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Preliminary Considerations

Before you venture into the more pragmatic aspects of selecting your augmentation size, such as trying on implants or determining measurements, working through some of these preliminary considerations can be immensely helpful.

What Kind of Look Are You Hoping to Achieve?

Breast implants crudely fall into two categories: those which are natural-looking, and those that aren’t.

One of the most common mistakes women make when they commit to breast augmentation surgery is succumbing to the desire for immediate gratification, which results in implants that are too large. As a result, the “boob job effect” becomes obvious.

While many women feel excited about the prospect of significantly larger breasts, particularly if your natural breasts are more modest in size, it’s important to follow the advice of your surgeon. Your surgeon can guide you towards beautiful cleavage that doesn’t appear obviously augmented or fake.

In the last few decades, there has been a shift towards a natural look that helps the patient look like a fuller and more ‘blossomed’ version of themselves. A competent, board-certified plastic surgeon can help you achieve a fabulous result that will stop people from guessing whether you’ve had surgery or not.

What Kind of Lifestyle Do You Have?

If you lead an active lifestyle, then awareness of how implants may impact on it is crucial. The larger the implant, the heavier the weight of the implant (doing the Rice Test or trying on implants for size can help you realize the difference).

Furthermore, larger implants move more during certain activities such as jogging or running, which can be distracting or uncomfortable. If you enjoy a range of exercise on a regular basis, or participate in any extreme forms of fitness, it is a good idea to share this information with your surgeon so he or she can advise you about the optimum implant size to allow you to enjoy your active lifestyle.

What Are the Risks Associated with Larger Implants?

Very large implants unfortunately come with a price. Implant sagging, tissue thinning, ripples beneath the skin and premature ageing of the breasts are some of the complications that can arise as a result of excessive breast augmentation.

From an aesthetic perspective, oversized implants can spill into the middle of the chest, or into the armpit region if the width of the implant is too large, or may overly project outwards (otherwise known as the “torpedo effect”). Problematically, revision surgery cannot always address the complications that could arise as a result of overly large breasts.

Many patients who are contemplating breast implant surgery feel compelled to ensure their investment is worthwhile by asking for larger implants than their surgeon may recommend. However, rest assured that your surgeon has expertise in selecting the right size to meet your goals within a range that is proportionate for you.

Being cognizant of cases where women have opted for excessively large implants and the complications that have resulted can also help inform your choice.

What Impact Will Your Implants Have as You Age?

When you have committed to breast augmentation surgery, it can be tempting to think about the breasts you want right now, as opposed to the breasts that are right for you in the long term.

As you age, your implants will also age and change. The ligaments that support the breasts lose elasticity and fatty breast tissue loses some of its natural volume, resulting in breasts which hang a little lower and appear flatter in profile.

With this in mind, very large breasts or those with a high profile (which project forward and appear “perky”) may feel or look unnatural. When considering your implant size or profile, take your age into account and how your implants will look as you get older to avoid having to downsize or change the profile of your breasts at a later date.

Breast size

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The Fundamentals of Breast Implant Sizing

Once you’ve devoted some thought to issues such as how implants may impact your lifestyle and long term goals, it is time to tackle some of the more mechanical and practical elements of implant sizing. There is no one-size-fits-all implant or right or wrong implant, but rather, a variety of different implants to choose from.

In general, implants are made from saline (salt water) or silicone gel. Both come with their own advantages and disadvantages. Saline breast implants feel similar to water balloons, while silicone feels closer to natural breast tissue. Silicone breast implants, however, require MRI exams at regular intervals after surgery to check for leaks.

In addition, implants are available in two different shapes: the more traditional round breast shape and the newer teardrop shape (also referred to as gummy bear implants).

Getting to grips with how implants differ and engaging in activities such as trying on and wearing implants in your bra, or taking measurements of your breasts and looking at before and after photographs of women who have undergone augmentation surgery, constitute valuable methods of deciding on the right implant size and shape for you.

Below are the four most crucial aspects of the sizing process to think about.

1. Volume

To the surprise of many women, breast implants are measured in cubic centimeters or cc’s, not cup size. As a rule, bra cup size is a relative and often imprecise measurement and can vary widely between bra manufacturers: for example, a Playtex B cup may more closely approximate a Victoria’s Secret C cup. Cubic centimeters provide an exact measurement of implant volume.

However, it can be challenging to conceptualize exactly the extent to which an implant of 330cc will augment your breast, which is why trying implants on for size can be so useful. Implants can range from 100 to 1000 cubic centimeters, but generally most women opt for 300-400cc implants.

2. Profile

Profile refers to the amount of “projection” that an implant has. Implants can be grouped into low, moderate, mid-range and high implant profile styles.

A low profile implant will be more subtle with less projection, while a moderate-profile implant will be noticeable. High profile implants enable you to have greater volume in a narrower width. Your preference regarding profile will most likely correspond to whether you wish for a more natural look or obviously augmented look.

However, saline and silicone implants do not perfectly correspond in profile: a low profile saline implant is closer in projection to a moderate silicone implant. In addition, if you have a broad chest, to gain the profile you desire you may require a larger implant of greater width to avoid the ‘ball in sock’ appearance.

Your surgeon can guide you regarding the factors that need to be taken into consideration. Trying implants on and handling them during pre-operative consultations also allows you to gain a real sense of how these profiles may feel on you.

3. Diameter and Width

The dimensions of your breasts and chest are vital considerations that will inform your future implant size. Width is the key dimension for fitting breast implants to your body properly. Breast width is measured in centimeters in a straight line from the outer edge of your breast next to your arm, to the inner edge of the breast (or point where cleavage meets).

Most women’s breasts measure between 11cm and 14cm wide. The tape measure is not curved around the arc of the breast in this measurement, but pulled tight across a flat plane.

Once your surgeon has determined your breast width, it is then possible to determine the dimensions of the breast implants that would be most suitable for you. Most surgeons recommend an implant that is slightly narrower or the same width as your current breast width.

If your breast width measures 13cm, then an implant with a diameter of 13cm or slightly less, such as 12.5cm, is a good fit. As a general rule, a slightly narrower implant is recommended by many surgeons.

4. Breast Tissue Thickness

The thickness of your breast tissue constitutes another issue that impacts your implants. Women with thicker breast tissue can generally accommodate wider implants than women with thinner breast tissue.

Placing excessively large implants under thin breast tissue can sometimes provoke complications such as visible implant ripples, because there is less padding covering the implant, causing the skin to stretch. Your surgeon will measure and assess your soft tissue thickness to help determine the right implant fit.

Breast tissue thickness can also figure in your selection of implant shape. There are two implant shape options you can choose from: teardrop implants, which first became available in 2012, and round implants. Round implants are circular in shape, whilst teardrop implants come in a range of different teardrop shapes that can fill out different elements of the breast.

Round implants are sometimes more appropriate for women with more than 2cm of natural breast tissue. The excess tissue sits comfortably over the implant, giving it the appearance of a teardrop shape after surgery. Teardrop implants work well for women with less breast tissue, offering a more natural appearance.

Breast Augmentation Recovery Stages

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Before and After Photos

Plastic surgeons think of breast augmentation in terms of implant volume (330cc, 360cc, etc.) while patients tend to think of augmentation in terms of cup sizes. This can sometimes create the potential for miscommunication or difficulty articulating exactly the look or increase in breast size that you want.

An incredibly useful and simple exercise that can help open up the channels of communication and pinpoint your goals is to look through before and after photos of patients who have undergone a breast augmentation procedure.

You can do this during a preoperative consultation with your surgeon and simply express your thoughts about the size and shape of the breasts in the images, and if they align with what you are hoping to achieve. Based on the images, the surgeon can recommend possible implant volumes to try on for size and offer advice.

Looking at photos is also useful because it can help you to realize that there is not simply one perfect breast implant size for you, but a range of acceptable and suitable sizes. However, it’s up to you to determine which size you like best.

Sizers: Trying on Implants

Trying on different implants offers an immediate way to gauge the size that feels most comfortable and appealing. During consultations and pre-operative appointments at your surgeon’s office, you will have the option to try on implants of different volumes, materials and profiles.

The most effective way to try on breast implants is to select a bra size you would like to fit and place implants inside it to simulate augmentation. Test a variety of shirts over the top so you can decide whether you like the look and feel of the implants, and experiment with different sizes until you settle on the right implant for you.

There is, however, one caveat to bear in mind with this method. While trying on implants is an undeniably effective way to get a sense of the size that suits you best, it can only ever give a rough idea: your breast size will appear different once the implants have been surgically placed inside your breasts.

Superimposing the implants on top of your breast tissue inside a bra essentially stacks one sphere on top of another, resulting in an exaggerated projection of the breasts. As a result, women sometimes select smaller implants than they wanted.

Another way in which you can “try on” implants at home and get a sense of implant weight is by carrying out the intriguingly named “rice test”. Instructions can be found here. Once you have made your own homemade implant sizers from pantyhose and rice, the implants can be placed inside a sports bra and tried on. You can add or remove rice from the pantyhose to experiment with larger or smaller implant volumes.

Sometimes, your choice may come down to two implant sizes. In these cases, the surgeon may recommend trying on the implant option during surgery using temporary breast implant sizers. The temporary implant will be placed in your breast pocket and assessed, and the surgeon will then make a decision about the implant that best fits your goals and your body type. The sizer implant is then removed and the permanent implant placed inside the breast.

Final Considerations

At the end of the day, the size of your new breasts represents a very personal choice. While the decision ultimately rests with you, don’t forget that your plastic surgeon is there to help support and inform you throughout the surgical process to ensure you achieve beautiful results.

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About The Author

Articles by

Emma Stone, PhD, is a contributing health and wellbeing writer for Zwivel.

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