When you are considering breast implant surgery, it’s exciting to imagine yourself with your new, enhanced figure and attractive silhouette. When the time comes to translate your vision into reality, however, you begin to wonder about breast implant sizes. It’s a crucial decision and it has to be right. Beyond the question of size, the sheer number of variables involved in finding the perfect implant for you can be daunting. Here, we’ll outline the characteristics of various implant types to help you sort through your options. Armed with this knowledge, you and your trusted breast surgeon can work together to create the look you want!

Breast Implants: How to Choose the Perfect Size

When you think of breast implants, it’s likely that your first thought is, “What size implant do I need?” As you’ll see later, there are many other aspects beyond just breast implant sizes that affect how they look overall. Shape has a great effect upon how large your breast implants will look. But let’s start in the logical place – size. Then, we’ll move on to the subtleties that can refine the look, so that your breast implants are perfect for you.

Breast implants don’t come in cup sizes. Instead, breast implants are sized in cubic centimeters (or cc’s), which actually refers to the volume—how much saline or silicone filler they contain. Choosing the right-sized implant is the key decision you and your surgeon must make. Every 200-or-so cc’s is comparable to one increased cup size—but this is relative because, as mentioned above, shape has something to do with it as well. Confused? Not to worry, your surgeon may have you “try on” breast implant sizes and, once the basic ballpark size is reached, he or she can provide expert advice.

What Size is Just Right?

To determine the ideal implant size for you, you and your surgeon will start by evaluating the following:

  • Your natural breast size. Your surgeon will evaluate whether you have sufficient natural breast tissue to cover the breast implant sizes that you’re considering. And yes, some implants may actually be “too big to fit”. Still, many women comment after the surgery that they feel they’ve been too cautious or conservative and feel their new breasts are “too small” once the initial swelling has subsided. Conversely, some women feel that their new breasts are “too big” soon after the surgery. The women consistently most pleased with their breast implant results are those who research carefully before hand, as you are doing right now. You’ll also make better decisions by choosing an expert plastic surgeon to advise you.
  • Your body/frame size (chest/ribcage and shoulder width). Breast implants come in different “base widths” so your surgeon can find a size that works well with your frame, while providing the look you want.
  • Breast symmetry. Many women need different-sized implants on each side, to create symmetry that is often lacking in the natural breasts before surgery. Now is the time to correct asymmetry if it has been an issue for you.
  • Weight of implants. The more cc’s you choose for your breast implants, the heavier they will feel. If you are going up a significant amount in your breast augmentation, be sure to think about weight, posture or even possible back pain. Discuss it with your surgeon and make a mental note when you’re trying on implants—to assess how they feel, not just how they look.
  • Your weight. If you plan to lose a lot of weight or become pregnant in future, there may be excess sagging of your breasts after augmentation. (There will be some natural, future sagging with age after any breast implant surgery, however.)
  • Your lifestyle: If you are an active athlete, work this into your choice of breast implant sizes.
  • Placement of the implant: Over the muscle or under-the-muscle, discussed below.
  • Incision site: In the inframammary fold (crease at the bottom of the breast), armpit, edge of the areola or belly button.

Your surgeon will walk you through all of these considerations to advise you about what size will work best to achieve your breast implant goal.

Tip: After surgery, allow yourself to acclimate to your new breast size over the course of a year, without second-guessing yourself about your implant size decision. Besides letting swelling go down, you also will need time to “get used” to your new figure. The new size may feel awkward at first, but later you will likely love it if you’ve worked closely with an experienced breast surgeon.

Texture Options for Breast Implants

Textured breast implant shells may decrease the possibility of rotation or capsular contracture (scar tissue tightly surrounding the implant) over time. Smooth surface breast implants can work well in the round shape because they may still look natural even if they rotate a bit over time.

What’s Your Breast Implant Profile?

Profile refers to how far your breasts will project out from your chest wall. There are several grades of projection, which manufacturers refer to as classic, moderate, high and ultra-high profile. The ultra-high has the smallest footprint or base width (the part that contacts your body), while the lower profiles are wider at the base.

Material Options: Your Table of Contents for Breast Implants

  • Saline implants – These implants can be filled and adjusted after insertion, requiring a smaller incision. In addition, they reabsorb into the body if ruptured but will deflate visibly (simply going flat). Saline can feel very natural if the surgeon chooses under-muscle placement and/or if the patient’s skin is thicker or has more natural breast tissue.
  • Silicone breast implants – Silicone implants are most popular, partly because they’re thought to feel more natural and conform well to the body shape. (Although saline implants, inserted below the chest muscle, can feel somewhat natural.) Silicone implants may be less prone to rippling, which can show through the skin if it occurs.
  • Gummy bear implants (also called form stable or cohesive implants) – Require a larger incision for insertion but may feel most natural and may be most durable.

Breast Implant Brands — Which is the Best?

There are subtle differences between the three brands (Allergan, Sienta and Mentor) that sell breast implants here in the US. Differences have to do with relative softness to the touch, amount of fill, tendency to keep their shape without rippling and more. This is another detail where your surgeon’s experience will prove invaluable.

All About Cleavage after Breast Implant Surgery

A top breast surgeon, with an excellent aesthetic sense, can help you choose the right breast implant sizes so that you don’t end up with, for instance, a too-widely-spaced appearance. This is a risk, especially if you have a bony chest, so choose a surgeon whose sense of anatomy and beauty you trust. Depending upon your frame size and natural breast width/anatomy, you may still need a push-up bra to create significant cleavage. Discuss exactly how you’d like to look with your surgeon, so that your surgical plan and breast implant sizes reflect what is important to you.

Breast Implant Placement: Over or Under?

Over (on top of) the pectoral muscle (subglandular implant placement): This placement option offers a shorter recovery period and can result in a slight lift, as a bonus. For those with thinner skin, this may not be a good option, however, because the look and feel could be slightly less natural. Choosing a silicone implant may counteract that issue.

Under the pectoral muscle (submuscular implant): This can provide a longer term “perkiness” with your body tissues acting as a type of interior bra. This placement, which is under your natural breast tissue, may allow for clearer mammography than the other option. Under-the-muscle placement may be ideal for thin women, since the muscle partially covers the implant. Recovery may take longer with this method, however.

Breast Implant Incision Decisions

Why would your surgeon recommend one implant insertion point over the others? Here are some of the pros and cons of each:

  • Crease (inframammary): Insertion via the breast crease is ideal for assessing symmetry in the operating room and can make any future revision a bit more straightforward.
  • Nipple/areola (periareolar insertion): Using an incision around the areola means that scarring is extremely well hidden.
  • Armpit (axillary): This creates only a tiny scar, but placement can be more challenging (done endoscopically) and any future surgery will mean another scar.

Getting Clear About Breast Implant Goals

How do you want to look after breast augmentation? Make it your mission to communicate this as clearly as possible to your plastic surgeon. Bring in a variety of photos of women/breasts and explain what you like and don’t like in great detail. Once your surgeon understands your desired goal for breast implant surgery, the process becomes much smoother. Your expert breast implant surgeon will help you navigate all the other details to achieve the very best result–the result you want.

Tip: Ideally, look for a reconstructive plastic surgeon (who focuses on breast surgery)—even if you are not undergoing a breast reconstruction. This gives you access to the highest level of skill and provides the best assurance of a stellar outcome from your breast augmentation surgery.

Improving Your Life Through Breast Surgery

At Cohen/Winters Aesthetic & Reconstructive Surgery, breast surgery is our calling. We are here to improve lives and we’re happy to advise you of your options for breast implant sizes and other details. You can easily find out if you’re a good candidate by contacting our NJ offices and scheduling your personalized consultation.

breast surgeon NJ

Dr. Cohen

About Dr. Cohen

Dr. Cohen specializes in breast lifts, augmentations, revisions and reductions as well as breast cancer reconstructions. A long time dream of Dr. Cohen’s was to travel to developing countries and provide expert surgical care to those who have no other possible access to medical care. This became a reality in 2007 when she became a founding member and Vice President of ISMS Operation Kids.