My general approach in selecting a size for a patient's breast augmentation is that it is the patient's choice. It is not for me to judge someone's taste or desires. My goal is to make the patient happy. The simplest way to figure this out is by asking the patient to show me a visual image through pictures of what size they think looks right for them. Then I try and match that size image in the operating room on the patient. While I do take breast measurements, the one measurement that means the most to me is the width of the patient's breast.If the implant size chosen by the patient is larger than their breast base width, then this is a reason to change to a breast implant that has a higher projection.I have found few women desire their breast implants to be too far to the side. A higher projecting breast implant pushes more implant volume forward rather than to the side.

In the majority of breast augmentation in my practice, I find that most women select sizes that would be viewed as 'reasonable'. Most of my breast augmentation patients choose breast implants in the size range of 300cc to 450cc. The rest of my breast augmentation patients get implants in the 450 - 700cc size range. In a taller and heavier patient, these breast implant szies may appear not unduly large. In more petite women, these breast implant sizes may be viewed as too large.

While it is not my concern when a patient chooses alarge breast implant, I have an oblication to inform them that there are some long-term consequences to that choice. First and foremost, it is easy to increase the size of the breast but it is difficult to go the other way. To go down in breast szie later in life, the excess skin may also have to be reduced to maintain a good breast shape, resulting in breast scars. Secondly, the bigger a breast implant, the more pressure it exerts on the remaining breast tissue resulting in long-term loss of their remaining breast tissue. In many large breast implants over time, the patient will only be left with skin and a breast implant with little breast tissue in between. Lastly, the weight of a very large breast implant over time may cause the entire breast to sag, weakening the skin support of the breast under its own weight.

Inchoosing large breast implants, patients need to know that how they may view their breasts years later may be quite different. Like that nice cute tattoo that was put on in your twenties, it may not look so cute when you are forty.