Josh Olson, M.D.

Revealing your beauty through science and artistry.

Dr. Olson's Blog

What size breast implants do I choose?

Choosing an implant should be an exciting part of preparing for breast enhancement surgery. For some it can also be an anxiety provoking decision, hoping not to decide implants that are too big or too small. Every plastic surgeon has their own protocol for choosing implants and I hope to further explain my process and hope to help you make a choice you will not regret.

Most Common Complaint?

More often than not, woman who undergo breast augmentation surgery say “I wish I would have gone bigger.” How does this happen? I think this is partly from choosing the wrong implant but also I believe the image patients are looking for changes after undergoing the surgery.

Many of my patients come in and say “I don’t want to look fake,” or “I want to look natural, just with more breast fullness – like before giving birth to my children.” This general concern for avoiding “too large” of implants can lead some to choose smaller than they are really wanting.

Furthermore, the first 4-6 weeks after a breast augmentation the implants tend to sit high on the chest wall. Concurrent swelling will give the appearance and feel of larger breasts. The overlying skin hasn’t had time to stretch so the person may just notice the implants more often than not. Over the next 2-3 months as the skin stretches and the implants drop into the more appropriate position there is a change, and the implants seem smaller than what they just got used to. I believe this is a major part of why women say they wish they would have chosen larger implants.

My friend says to go at least 400 because that’s what her friend did and she looks great!

I hear this all too often. Patients tend to want the same implant size as their friend or based on their friend’s advice to go bigger. This unfortunately leads to some poor decisions and regret. Every woman’s body is different and even their own breasts will differ to some degree. Your rib cage may be wider or breast shape and width may be totally different so even if you both had the same exact implants you can end up with a completely different look. The natural breast size may differ and this also will change the outcome.

My Recommendation?

In my office, the last thing I want is for you to regret going too big or too small. Recently quite a few women have consulted with me to exchange their larger implants with smaller. When I ask how they chose the size they unanimously have said their surgeon chose for them. I feel this should be a joint decision between the patient and doctor as only you know what you want. I’ve been married too long to even attempt at guessing what a woman is really wants. I use the Mentor sizing system which involves using shaped gel implants that are placed in a bra. I recommend bringing a solid color shirt, one that is a relatively tight fit, for your initial consultation to use with the sizing system. Then, looking in the mirror and trying on different size implants, you tell me what size you are hoping for. After taking your chest wall measurements and determining which size you like, we jointly decide what will best fit your body and give you the look you want. I give my personal opinion but ultimately you are deciding the size you want as long as it’s within reason.

Concluding Thoughts:

In conclusion, there are a multitude of factors that go into choosing the perfect implant for your body including: chest wall shape, breast footprint or original breast shape, hip size/shape, your overall goals, activity level in sports and a history of child birth and/or breast feeding. No two breasts are alike and don’t sell yourself short by choosing what size your relative or friend tells you, or even your surgeon for that matter. This is your decision and I only hope to be a resource to help with that decision. Call our office today to set up your consultation.


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