Many of my patients ask how I choose the optimal size for a breast implant. Some women are very concerned about choosing too large of an implant, as they know this can make their breasts look unnatural. Other women are afraid that they won’t choose a large enough implant to see a discernible difference. There are a variety of tools that I use to help my patients select the best breast implant size:
- Photos. Having patients bring photos of breasts they like and breasts they detest help me determine their goals. Some women desire subtle enhancement and others desire much more dramatic enlargement.
- Measurements. The chest wall diameter, breast width and height are all important factors in selecting an appropriate implant. The breast skin envelope is only so large; selecting an implant that is too large invariably means that implant will sit too high, too low, or too lateral.
- Trial sizing. Although it is inexact, having patients try different implants in a bra in the office is a useful exercise. It gives them a crude idea of breast size and shape in clothing and often helps them verbalize their goals.
- Conversation. Different implants have vastly different shapes and profiles. It’s important that patients understand how this differs in appearance from other types of implants, and that can only conveyed adequately in the preoperative consultation.
- Intraoperative sizing. I will often utilize intraoperative trial implants and always sit the patient up during surgery to ensure that the breasts have a pleasing appearance. This is particularly the case for patients with breast asymmetry, to ensure that the final implants utilized provide the greatest possible symmetry.