Breast Augmentation: How Big and How to Decide?
Breast Augmentation is clearly one of the most popular procedures women elect to undergo. It is a safe procedure associated with enduring results and extremely high patient satisfaction. Significant improvements in implant technology have improved the results.
When I ask clients why they are considering breast augmentation, the answers range from a desire to look better in certain clothing or to achieve an improved physique with idealized body proportions. For example, a client with fuller hips may feel larger breasts will achieve an improved balance of proportions.
Whatever the reason for electing to undergo breast augmentation, one of the most important decisions to be made in consultation with your physician is what size implant to choose.
I have observed that, compared to breast augmentation of the 1980s and 1990s, clients are opting for smaller implants. What appears to be driving this phenomenon is the desire for a more athletic physique. Many women complain that large implants interfere with their exercise routines – especially running. With the passage of time, larger implants are viewed as an inconvenience and impediment, and we frequently have requests to remove or downsize implants. Pop culture imagery and fashion have gravitated toward sleeker feminine physiques, as opposed to the more buxom look of a few decades past. For these reasons, clients nowadays are opting for relatively smaller implants.
Breast implants are sized based on of the volumetric unit of cubic centimeters – abbreviated as a cc. In non-metric terms, there are roughly 30 cc in an ounce. As a general rule, for a client with a 32-inch chest diameter, each 150-175 cc represents a cup size. Of course, this depends on the bra manufacturer as well. For example, I note there appears to be a degree of cup-size inflation by certain bra manufacturers – perhaps to instill a sense of fulfillment in the customer.
Armed with these rough metrics, one can begin to estimate how large of an implant to consider depending on one’s end goals. For example, a client who is naturally a B-cup and desires a final D-cup size would consider a 300-350 cc implant.
When considering breast augmentation, the aesthetic goals include creating cleavage, improving breast projection, and elevating the nipple-areolar position. In some instances, excess skin in the axillary fold, which is the skin in front of the armpit, may be addressed by recruiting into the newly augmented breast mound. I also ask clients to consider how the augmentation will fit with the rest of their body.
In the past, in order to help clients choose the size of breast implants, we would use the rice bag test. Using a kitchen scale to determine the amount of rice, clients would then add the rice to a sandwich bag which they would insert into a bra to approximate the augmentation. Thankfully, we have advanced beyond the rice bag test. We offer Anatomic Soft gel Sizers that the client uses to approximate the implant size. When presenting for consultation, I advise clients to bring two bras and a fitted T-shirt to get an idea of what their breast augmentation result will look like.
In a further advancement, we use the Crisalix virtual imaging system to refine implant size selection. The process is easy and involves generating 3D patient images, which is done at the time of consultation. The program contains all commercially available breast implants that can be selected and used to augment the virtual images. The client has the benefit of viewing themselves in an immersive 3D environment using a virtual reality head-mounted display (VR HMD).
I hope this perspective on breast augmentation provides some valuable insights as you consider plastic surgery.
Dr. P. Pravin Reddy is a Board Certified Plastic & Reconstructive Surgeon and a proud member of the American Society of Plastic Surgeons. Dr. Reddy of one of the few Plastic Surgeons with advanced training in Breast Surgery.