How Can I Be Sure I Get The Breast Implant Size I Want?

Q: Dr. Eppley, I have interested in getting breast implants and have been researching the topic for the past six months. I have been to several consults and received differing opinions as to breast implant size. One surgeon even showed the result of an ‘extreme breast augmentation’ which frightened me. I take pictures of what I want into the consults but how do I know that is what implant size they will use? Some seem to listen to me while others I don’t think are and I am afraid they will just put in what they want.

A: Every plastic surgeon has their own approach to choosing breast implant size. Presumably the size selection should be what the patient wants. In my opinion, within reason, one should try and get as close as possible to the patient goal by using pictorial help. In the end it is not really about volume in ccs or bra cup size but what breast look the patient wants.  With few exceptions, just about any implant size can be put in most patients. I find pictures very helpful as I use them in the OR as a visual guide with the initial placement of sizers, only pulling the sterile implants once the breast looks like the pictures with the sizers in place.

There is a definite trend today, used by some plastic surgeons with great rigidity, that they will not place breast implants ‘that exceed the tissue support to sustain them’. That is a bit of a subjective assessment but what it means for some patients is that they will get smaller breast implants than they really want. While smaller breast implants are often associated with fewer long-term problems than larger ones (tissue stretch and sag), it can be a delicate balance between meeting the patient’s goals and keeping the implant size from stretching the breast tissue too much. I would sit down with the plastic surgeon in which you are most comfortable and put your objectives and concerns on the table for an open discussion.

Dr. Barry Eppley

Indianapolis, Indiana