Should I order that large entrée sized salad or still be hungry after eating the smaller appetizer salad? Will that 42” LCD TV look too small in the room or should I splurge and go for the 60” model. Do I want to live in a small apartment or a nice roomy house with a yard in a quiet neighborhood? Despite what you may have heard, size does matter.
With breast implants this is very true as well. When women come to see me in consultation, their first concern is about size. As is their second… They don’t request “I would like textured implants – in whatever size you have available.” or “Just give me something above the muscle.” No, it is size, size, and size. This is a variation on the mantra for a successful business where it is location, location, and location. Many studies show that the number one reason for reoperations in breast augmentation is unsatisfactory breast implant size. Nearly always it is because the size selected was not big enough.
Complicating this size issue is a misconception of what volume and proportion different cup sizes represent and what is truly proportionate or “fits my body”. One company’s “C” bra may fit exactly like another company’s “D” bra. Furthermore, many women think that a “B” is considered normal and proportionate whereas a “C” is too big. If I had proceeded to give them what they “wanted”, there would have been a lot of unhappy patients. We have had requests for a “small C”, a “regular C”, “large C”, a “small D”, etc. Have you ever gone to buy bras and asked the sales person to show you the selection of 34 large C bras? Or 36 small D bras? She would probably wonder what hole in the desert you crawled out from. There are no such bras! I’ve never seen them. Of course, then again, I have never personally bought a bra either!
Another issue aside from cup size and proportionality is that often women don’t really know what they want. Women want to be bigger but to what degree? What is too large or not large enough? What may be too big for one woman will be too small for another even though they voiced similar desires. I have found a few constructive ways to help my patients determine what they are really looking for. Trying on implants in the office, although not entirely accurate, gives my patients a 3 dimensional perspective that they can relate to. The photographs of a wide variety of previous breast augmentation patients with specific cup sizes are reviewed. Pictures from magazines or the internet can also be helpful but are limited by several issues including their two dimensional nature, clothing (on some), air brushing, resolution and perspectives. Some people on their own have used bags of rice stuffed into bras to help in sizing. Don’t try doing this with pasta – raw or cooked. It will not usually be a pleasant experience. I find that by carefully listening to my patients, seeing where they are coming from, their overall goals, etc., plus some intuition, I virtually always can determine the general appearance/size that would make them happy.
Based on all this input from my patients and their assessment, I make the final decision on the ideal implant size during surgery. If there is any doubt, it is always better to go a little bigger than a little smaller.
Yes, size does matter!
Steven H. Turkeltaub, M.D.