Breast Implant Sizing: Why Bigger Isn’t Always Better

When you know you’re ready to pursue breast implants, you still have several important choices to make. From material to size and profile, every step in the decision-making process should reflect your goals, your lifestyle, and your long- and short-term priorities. One of the biggest factors is determining exactly how big is big enough—and how big is too big. Getting the right fit is a balance between your aesthetic goals and what will look and feel best on your frame. The good news: expert plastic surgeons are adept at helping you find your perfect match.

Breast Implants 101

“There are two main types of implants,” says Denver plastic surgeon Philippe A. Capraro, MD. “Saline implants, which are filled with salt water, and silicone implants, which are made these days with a thick, cohesive gel.”

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“Silicone generally feels more natural and soft,” says New York plastic surgeon Elie Levine, MD. “Small saline implants can feel natural and soft, but when you start getting to moderate and large sizes, they begin to feel a little less natural.”

All FDA-approved manufacturers offer a variety of widths, projections and gel firmness options.

“Natrelle provides both silicone and saline implants,” says New York plastic surgeon and Natrelle partner David Shafer, MD. “Their silicone implants come in varying levels of gel cohesivity, often referred to as ‘gumminess,’ allowing patients to select the feel and shape that best suits their aesthetic goals.”

Choosing the Right Size

“As far as picking the appropriate size, it’s about body dimensions, taking into consideration height, weight, and critically, breast width,” explains Mountain View, CA plastic surgeon Shahin Fazilat, MD.

“This refers to assessing the patient’s anatomy including their musculoskeletal structure, breast measurements, tissue characteristics and skin quality,” adds Columbus, OH plastic surgeon Robert Centeno, MD. “This evaluation helps determine what size, style, profile implant and placement technique would be most appropriate to achieve the desired outcome.” From these measurements, your surgeon will provide a range of implant sizes that will work for your body.

“There is a specific range of implants that will fit inside your breast and body,” explains Grand Rapids, MI plastic surgeon Bradley Bengtson, MD. “Matching the width of the chest wall to the width of the implant is critical for natural-looking, proportional results.”

According to Dr. Capraro, there’s still some wiggle room. “When a patient has made their choice, I tend to order one size smaller and larger just in case, which is the difference of an ounce,” he says. Key to this process is seeing how different profiles, projections and sizes will look on your body.

“In the office we can use various technologies to help patients simulate their augmentation results,” explains Beverly Hills plastic surgeon and Natrelle partner Kelly Killeen, MD. “There are also physical sizers you can place in a bra for simulation. There are even some augmented or virtual reality technologies which can help give you an idea of how your augmentation will look!”

Why Going Bigger Isn’t Always Better

“It’s important for a natural look to pick an implant that is not too wide, which causes it to stick out on the lateral chest wall,” explains Dr. Fazilat. “It’s my job to explain that the wider you go, the more likely you are to get that unnatural look.”

“While it is often physically possible to put in larger implants that naturally fit the patient’s frame and breast dimensions, this decision comes with both short- and long-term consequences,” explains Dr. Centeno. “Short term, it can come with more postoperative pain and [longer] recovery. Long term, going too big can increase the risk of reoperation for multiple factors including size change, implant malposition, making asymmetries more noticeable, accelerating breast drooping, capsular contracture or hardening, and seeing or feeling the ripples of the implant due to tissue thinning.”

Choosing an implant that fits your body’s natural dimensions helps minimize these risks and increases satisfaction in the long run. Breast augmentation continues to be a highly popular procedure with high satisfaction rates—especially when implant size is chosen thoughtfully.

“Implant choice is more than just choosing a cup size, the key to a beautiful result is an implant choice that fits your anatomy,” says Dr. Killeen. “Your surgeon will examine you and then be able to guide you to implant choices that will fit your frame and help you achieve your desired look.”