“No one who has seen a baby sinking back satiated from the breast and falling asleep with flushed cheeks and a blissful smile can escape the reflection that this picture persists as a prototype of the expression of sexual satisfaction in later life.” - Sigmund Freud

The breasts are one of the most prominent parts of a woman’s body and a primeval symbol of femininity, maternity and sexuality; it's no wonder breast augmentation is the most popular plastic surgery procedure today. (Learn more in 8 Things You May Not Know About Breast Augmentation.) When a woman visits her plastic surgeon for the first time, she, in collaboration with her doctor, is called on to answer two main questions:

  • Which size of implants is suitable for me?
  • What shape of implants should I choose?

What we should always bear in mind is that there is not — and should not be — a one-size-fits-all way to address this question. When making the right choice of implant, there are some factors that should be taken into account:

  1. The desire and expectations of the individual.
  2. The plastic surgeon’s experience.
  3. The unique characteristics and proportions of each body.
  4. Skin elasticity.
  5. The patient’s lifestyle.
  6. The size of existing breasts.

Breast Implant Sizing Considerations

At a first appointment with a plastic surgeon, many people try to describe the size of the breast they have in mind depending on the bra size they would like to wear after the surgery. In the brassiere, the part corresponding to the breast volume is the cup size, which is described as A, B, C, D, etc. It is very common for women who wear 34A, for instance, to ask for a 34C bra size.

However, since the size of the implants is measured in cubic centimeters of volume (1cc=0.03 ounce), what you actually have to consider is how many cubic centimeters result in a change in the bra size for you in particular. According to research by the American Society of Plastic Surgeons, it seems that an average of 130-150cc (4.4-5 ounces) is needed to achieve a size increase of one cup.

This number, however, doesn't apply evenly to all situations. Every woman’s body has its own needs, depending on the chest diameter, implants’ projection, the intended shape of the breast etc. Breast implants start from 80cc and reach up to 800cc. Typically, the sizes requested by women range somewhere between 300cc and 350cc to 400cc corresponding to a projection (the maximum height of the implant) of 1.2-1.6 inches. However, petite or more athletic women tend to prefer smaller sizes, as they look for a more discreet result, or smaller breasts to match their everyday activities and lifestyle.

One of the best and most accurate techniques for choosing breast implant size is to bring photos of women who, in your opinion, best match your idea of perfect breast size and cleavage and show them to your doctor. Ideally, the photos you pick should be of women with the same general body type as you. By this means, your doctor can determine more clearly your wishes and guide you more effectively on your final decision.

Your First Consultation With Your Doctor

During your first consultation, it is more likely that your surgeon will give you some implant sizers to try on, so you can see which best fit your needs. These fit inside your bra to provide you with a sense of how your implants will look on you. For this test it is a good idea to wear a tight shirt in order to get a better picture of the result.

That way you will have a rough idea of how your body might look following your surgery. Take into consideration, though, that the implants tend to appear a little bit smaller after the procedure, due to the pressure of the tissues that cover them. A good rule of thumb is to add 50-100cc to your initial choice. In other words, if you concluded the 300cc implant sizers work best for you, you should use 350-400cc breast implants, so that they correspond more to the image of your body those sizers presented.

In the end, the implant size that is more suitable for you is objectively – and more scientifically - defined by the anatomical measurements conducted by your plastic surgeon, either directly, which is usually the case, or with the use of a computer. These consist of mainly the measurement of your breast base and hip width, and the evaluation of the composition of the soft tissues. By these means, the most appropriate width of the implant can be safely defined.

This basically ensures that your breasts are neither too big nor too small. A tall woman with broad shoulders and a natural A-cup may need 450cc of volume to reach a C-cup, while a more petite B-cup size patient may need a 250cc implant to have the same effect. For each patient, there is an equal range of implants that either look natural, or abnormal.

Choosing the Shape of Your Breast Implants

In breast augmentation, there are two shapes of breast implants:

  • Anatomical, or tear-drop
  • Round

Most women use round breast implants, as they conform to the natural breast shape and give a fuller look. They are most preferred by patients a B-size cup and above. Anatomical breast implants are used more often by women who have undergone mastectomy, wherein a large part of their breast has been removed. They may also be used by very thin women with low fat in the chest area, or by women with small breasts, as, in all occasions, they provide a more natural look than round implants.

However, what really makes an impact on the breast appearance is the way the surgeon places the implant, not the shape of the implant itself. An anatomical implant put underneath the chest muscle barely keeps its initial shape. On the other hand, round implants placed under breast tissue with great tension can resemble tear-drop implants.

The Bottom Line on Breast Implants

Unfortunately, there is no way for women to predict with absolute precision how their breasts will look after the procedure. Simulations of any kind provide a rough idea of size and shape, but cannot accurately portray the patient's own body and individual results. In order to get the right choice, first you must have a clear view of your expectations and your limitations.

Breast augmentation has a contouring effect on your body, so you should really ask yourself how you want your body to look, rather than how you want your breasts to look. And, as beauty is in the eye of the beholder, it would be a good idea to see pre- and post-operative pictures of the patients of plastic surgeons you are considering, in order to make sure that the shortlisted surgeons fit your aesthetic.

After all, what matters most is to see a happy, healthy and confident person in the mirror.