The more breast augmentation consultations I do, the more I realize that there seems to be a lack of help, for some patients, to determine the correct size and style of breast implant for breast augmentation. Whether this is due to a failure of plastic surgeons to assist their patients in the decision making process, a lack of understanding on the patient's part of the complexity involved in choosing implants, or an overabundance of haphazard information from both the surgeon and the internet that ultimately confuses patients.
The decision to undergo a breast augmentation is very personal and often takes courage and conviction. Use that assurance to educate yourself so you can be a partner with your plastic surgeon in the choice of your new implants. By doing this, you can avoid any postoperative disappointment and the potential for additional surgery.
In an effort to help all patients, here are 10 thoughts patients need to consider when choosing breast implants.
The most common request I hear during a breast augmentation consultation is "I'd like to be a "C" cup." And, although I have come to interpret this as "I'd like my breasts to look like they fit my body" that may not mean you'll be a "C" afterwards. All bra manufactures size differently and therefore bras from different manufacturers will fit differently. You may be a 36 C in one bra and a 34 D in another. So don't worry about the bra size. If you end up as a "D" cup but are happy with the appearance of your body then the bra size is irrelevant. Work with your surgeon to determine the implants that give you the look you desire.
Height, weight, body frame, shoulder width, hip width, buttock and starting breast volume all need to be taken into account when choosing an implant. In general as all of these areas increase in size (except starting breast volume) the larger the implant necessary to maintain proportion. A woman 5'3", 110lbs with a small frame will typically need a far smaller implant than a woman 5'10", 145lbs with a large frame. It's not easy to stand in front of a mirror and take a very critical look at your own body. But doing so will greatly increase your knowledge and appreciation of your body and therefore your ability to choose the correct implant.
Whether you're an outgoing, Type A personality or a quiet, shy, Type B personality there's an implant that will enhance your body while maintaining the real you. It is important that you convey to your surgeon how you want to be perceived by the public. Breasts that are exceptionally large (even disproportionate) may be perfectly suitable for women in certain professions. But implants that create breasts that are proportionate will allow clothing to fit well, make you look great in a swimsuit or cocktail dress, all without diminishing your credibility at the office.
If you're the type that likes to seriously sweat at the gym, run or bike extensively or do any kind of serious sport, then you have to consider the trade off between larger breasts and performing your activities at your current comfort level. This isn't to say that breast augmentation will limit your activities. But, larger breasts will feel differently, need more support and frankly if too large, could be cumbersome during workouts. You need to have a frank discussion with your surgeon concerning this. A smaller or lower profile implant may be necessary to achieve your goals.
Both Allergan and Mentor make low, medium or moderate, and high profile implants. As implants move from low profile to high profile the amount of projection increases and the base diameter decreases for any given volume. These implants can either be round or shaped (also called anatomic, contoured or tear drop). Specially shaped implants are used in breast reconstruction; there is no need for them in cosmetic breast augmentation. Shaped implants provide shape when there isn't any but have the potential to rotate causing problems.
To make it easy, a majority of patients will be appropriately enhanced with the medium profile implants. The only real difference between the two companies is that there is slightly more projection with the Allergan implants than the Mentor implants for any given volume.
I have found that high profile implants tend to suit shorter, smaller framed women with a narrow base width. Conversely, low profile implants are great for upper pole fullness in augmentation mastopexy, or to add fullness without the added projection in women with adequate breast tissue.
Another common comment is "my girlfriend has 400's so I think I should get the same because they look great on her." But the operative words here are "on her." Even though you and your friend may seem similar in terms of body size there are too many other factors that must be considered to make such a blanket statement. Think of this process as the ultimate in customizing, so be open to needing a different size or style implant.
Sizers are silicone gel implants that can be used in the office to give patients an idea of what they can expect after surgery. Wearing a tight sports bra while trying on sizers gives better compression and thus a slightly more accurate idea. However, sizers tend to sit lower in the bra than breast implants, so your surgeon needs to guide you while trying them on. They aren't perfect but they do give a good estimate of postoperative size.
I tend to spend a lot of time, during all of my consultations, educating patients on all areas related to breast augmentation. Because there is a lot of information to digest patients don't always hear or remember everything that I tell them. Having a friend or relative with you during the consultation increases the amount of information that is attained. In addition these friends, if they understand your desires, can lend another set of eyes that can help determine the best implant.
At the initial consultation, patients and I will decide on the correct implant together. If there is doubt, it can usually be clarified at the preoperative appointment. Occasionally patients have difficulty visualizing the postoperative appearance of their breasts, even with the sizers in. They're simply not accustomed to the new look and have difficulty determining if the implants they have chosen are exactly what will give them the appearance they have envisioned.
In these cases, I have the patient see me for an additional appointment or more until they are confident in the choice of implant. Although most surgeons don't do this, don't be afraid to visit your surgeon on a separate occasion. Bring different outfits so you can see the full effect the surgery will have.
I have found through my work with websites like RealSelf.com that patients are often left out of the decision making process or simply allow their surgeon to determine the correct implants, only to be disappointed with the outcome. Determining the correct implant must be a collaborative effort between patient and physician. Use your surgeon as your guide. Use his knowledge, sizers and experience to come to a conclusion that is appropriate for you.