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Size Matters

By Patty Reiman
Posted On Aug 07, 2010
In the quest for the perfect breast size, proportion is the key

Words Lisa Cohen Lee  /Photography Edwin Santa
Styling Chad Cox Hair / Makeup Eliut Tarin

Here’s a universal truth in the world of cosmetic surgery: Size definitely matters. And when you’re considering breast implants, bigger—whether you want to hear it or not—is usually better. In fact, one of the top reasons women go back for a second augmentation is that they feel they didn’t go big enough during the first surgery. But going up in cup size isn’t as easy as saying B, C or D; picking the right size for you takes much more into account, like your body type, frame and stature. In other words, your overall physical proportions.

“In my experience, patients want what looks most natural and balanced. The best result is the fullest size that’s comfortable and works for your frame,” says Marc Yune, MD, a board-certified facial plastic surgeon based in Atlanta, Ga., and fellow of the American Academy of Cosmetic Surgery. But before you sit down with your doctor, read on to get the facts on how to choose your best breast size.

Rethinking the ABCs

Whatever you know about cup size, forget it, say the experts.

“Cup size is almost arbitrary when you’re talking about implants,” says Jacob Haiavy, MD, a board-certified cosmetic surgeon in Rancho Cucamonga, Calif. “Sizes aren’t consistent between bra manufacturers—there’s no universal size measurement—so it’s important to educate patients on how to choose the right size for them based on volume and fullness.”

With breast augmentation it’s all about the double Cs: the cubic centimeters that measure the volume of an implant. Your current size—say an A cup—will determine how many CCs you need. The average implant size is about 400 cc, which brings an A cup up about two sizes bigger. If you start with a larger bustline, the same sized implant may look bigger—or not. It’s the other factors, like your body frame and stature, that make a C cup look big on one person and smaller on another.

Measure Up

Before your doctor suggests an implant size, he’ll take a full set of measurements: the circumference and width of your breasts, shoulders, hips and more. “I look at the shoulders, chest, height and weight to dictate what type and size of implant I’ll put in. It’s what will fit a person’s body. For instance, if the patient’s breast base width is smaller than the size of the implant diameter, I advise going down a size to avoid looking disproportionate. Reversely, with a patient who has a wider base, I’ll recommend going bigger as an option,” says Dr. Haiavy.

Also, keep in mind that height is important. If you’re petite, you want to avoid looking top-heavy. If you’re tall, you may be able to go bigger than you had initially thought.

Try it on! Breast Size Rice Recipe
To make your own homemade “implant,” you’ll need a pair of knee-high hose, rice and a glass measuring cup with ounce measurements. Use your doctor’s recommended range, measure out 1 ounce for every .30 cc (for example, 400 cc = 13.5 oz). Fill a stocking with the rice, and then repeat for the other one. Place each stocking in your bra, and take a look in the mirror, noting the feel and the look. Try on different clothes and even a swimsuit, to get an idea of your proportions. Experiment by adding more ounces or taking away some (write down notes so as not to forget your final decision), until you find the size you’re most happy with.

Visual Assets

Seeing before-and-after pictures of women similar to your body type helps too, but to get a more exact picture of how you’re going to look post-op, your doctor may use 3-D video imaging.

“We take a whole body shot, and then show with computer graphics a realistic picture of how the larger size will look on your body. I find it’s a great tool for discussions on size and surgical planning,” says Dr. Yune.

Although it’s not a perfect barometer (Dr. Yune says it’s about 90 percent accurate of how the increase in volume will look), computer imaging can give you a general idea of what your new implants will look like in proportion to the rest of your body.

Your surgeon may also have you try out sizers (actual saline or silicone implants) in the office. “It’s truly the best method to determine size and proportion because you can actually see how you’ll look immediately with the final result,” says David B. Brothers, MD, a board-certified plastic surgeon in Atlanta, Ga.

Still not sure? Making a low-tech, homemade “implant” with uncooked rice, and trying it on inside your bra is an easy way to see what looks and feels most comfortable in private, says Dr. Haiavy. Even though rice is not as dense or full as gel or saline, it still can give you a general feeling about your ideal size. (To try this, see Try It On! Breast Size Rice Recipe, p.75)

Natural Instincts

Whatever size implant you have in mind, the goal is to give you what looks natural. “You don’t want to have a surgical, overly operated look that is a tell-tale sign of implants,” says Dr. Yune. “It’s got to look normal for you and your proportions.”

You’ve had the surgery, and you’re ready (and need!) to go buy new lingerie. But for most women, finding a bra with the perfect fit is the holy grail of post-implant bliss.
“Bras are made to fit the shape of the breast. An implant is fuller and rounder than natural breast tissue,” says Dr. Brothers, who spent more than 10 years developing a bra specifically for the augmented breast (see below). “Because an implant is more forward, and doesn’t droop, post-op patients often find that their bra doesn’t fit properly.”
Likewise, augmented breasts have wider cleavage since the implant is often under the muscle, and most bras don’t compensate for the increased width.
Your best bet post-op (doctors usually recommend a month after) is to visit a professional fitter who will guide you to the right size and correct fit. Your band size (the measurement of your rib cage) remains the same; it’s the cup size that will change.
And don’t be surprised if you wear a 34D from one company, and a 34DD in another.
When you try the bra on, the band should sit level along your back and breasts–even when you’re moving. When you look in the mirror at the cups, there should be no spillage over them and the center connector should touch the chest wall. Your straps should stay put, and not dig into your shoulders. You also shouldn’t have to adjust your straps to give your breasts a lift.

Ultimately, the decision is yours, and it’s important not to let outside influences, whether from a spouse, partner, friend or the media, dictate what size you want to be. Your best bet? Look to your doctor for guidance.

“If I feel a patient is trying to please a husband or boyfriend by going up to a size she’s not comfortable with, I reiterate that the final decision is hers,” says Dr. Haiavy. “I also emphasize all the problems associated with bigger implants, including sagging and back pain, and that eventually you may need another surgery for a breast lift. If she’s still being swayed to go bigger than she wants to by her partner, then she’s not the right patient for the surgery.”

Explain to your doctor your preferences when it comes to size, reaffirming your goal and the reason you’ve elected to have augmentation. And, most of all, be open. Your doctor’s an expert and the combination of his opinion and your own form the basis of a successful surgery.