Breast Augmentation Consultation: How to Manage Expectations and Get Better Results

Don't walk into your breast augmentation consultation with expectations inflated by research, goal photos, cup size, and patient testimonies. You could leave deflated.

These and other tools like breast implant sizers and computer imaging technology are only meant to guide your plastic surgeon into creating the treatment plan that works best with your body and produces better results.

Our tips have been signed off by San Diego plastic surgeon Tom Pousti, and they'll show you how to keep expectations in check so you get the right augmentation.

Recognize the limitations of different breast augmentation and implant types

If you've done your research, you've found there is a lot more to breast augmentation than choosing saline or silicone implants. There are various implant shapes, textures, placements, incision sites, and profiles—all of which have disadvantages and advantages.

For instance, if your breast skin has lost laxity and the tissue within is thin, asking your surgeon to place sizeable implants over the muscle, through the inframammary fold, would not be ideal. Your surgeon would likely ward against these methods, citing potential complications like bottoming out and breast implant extrusion.

Building a repository of research on the variety of breast augmentation techniques and implant types will keep you open-minded so that after your plastic surgeon has done a breast exam and outlined his treatment plan, explaining why it works best for your breasts, you'll be receptive.

One JBI member used our forum for a large part of her research. "I went into my consults knowing so much already and that felt good."

Understand breast width diameter will determine your implant size, not you

Breast width diameter (BWD) is perhaps the most important consideration when it comes to choosing breast implant size, shape, and profile. It is the measurement taken from the width of your breasts—from cleavage to the outermost edge. This tells your surgeon how large of an implant will fit, and what profile or projection.

So, don't be surprised if your vision for larger implants doesn't match your surgeon's proposals. He will give you different size options based on your individual BWD. Expect implant recommendations that are a little narrower or approximately the same width of your breasts. This is the standard rule.

Going larger than your breast width diameter would mean your surgeon would have to over-dissect your breast pockets, a contributing factor to complications like symmastia (uniboob), bottoming out, breast implant rippling and palpability, and even breast implant extrusion.

Don't confuse cup size with breast implant size

Many women go into a breast augmentation consultation requesting a certain cup size. They want to achieve a C cup or D cup. Unfortunately, implants are sized in milliliters (cc) of volume. They can range anywhere from 80cc to 850cc, and come with a base width of 7.4cm to 17.2cm. This can cause confusion when choosing implant sizes if you look to your current cup size as a marker.

"It is not suggested that you communicate your goals, or evaluate the outcome of the procedure, based on cup sizes," according to San Diego plastic surgeon Dr. Tom Pousti. "There is simply too much variability when it comes to bra sizes between manufacturers and even store employees doing the bra fitting measurements."

The Institute of Aesthetic Surgery agreed, but also pointed out that "a particular volume will not necessarily confer the same cup size to different patients. Often times, it will not even confer the same cup size to different breasts in the same individual. Remember, they are sisters, not twins."

Remember that breast augmentation goal photos are just that—a goal!

You should find and take goal photos to your consultation so your plastic surgeon can get a sense of what you are trying to achieve. But understand this:

It's easy to assume you can pick a photo, take it to a surgeon and say, "I want these breasts." That's not exactly how it works. You can’t place an order for breasts like you would place an order for fast food at a drive-thru. From the amount of breast tissue you have and your skin laxity to the spacing of your breasts and breast width diameter, your anatomy plays an enormous role in the final outcome.

For example, if you have breasts that are spaced widely apart, you will still have breasts that are spaced widely apart after your breast augmentation surgery. The opposite is also true. If you have breasts that are naturally close together, a plastic surgeon cannot make them farther apart.

Instead, trust your plastic surgeon to use your goal photos to produce a similar result for your own breast and body type.

Learn how to describe your breast augmentation goals before your consultation

There are things about our breasts we wish were better, and it's why we seek breast augmentation. However, those issues won't get fixed if you can't articulate what about your breasts could use improvements.

Describe the concerns you have about your breasts to yourself, first, then perfect the conversation before your consultation. You might say:

  • My breasts have lost a lot of upper pole volume. I want my breast implants to provide more cleavage and projection.
  • I want my breast implants to have a natural breast shape and feel, with a slight sag at the bottom to mimic a real breast.
  • I prefer my breasts to be round and firmer.
  • My areolae are large. I'd like them to be reduced so they look more proportionate to my new breasts.

Coupling specific language with breast augmentation photos and computer imaging are great tools that help your breast implant surgeon better understand your wants.

Don't rely on communication and imaging tools alone to predict your breast augmentation results

"Although useful as rough guidelines and as communication tools, all of the modalities currently used to predict what breast implant size or profile will best achieve a patient's goals with breast augmentation are not very accurate," said Dr. Pousti. "The use of the rice test, sizers placed beneath a patient's bra, goal photos, computer imaging technology are all useful but not necessarily accurate as one would hope."

In fact, many surgeons suggest that though breast implants are additive, when placed under the muscle, patients lose 10 percent of their size due to muscle compression. "The volume of the implant does not really change, the projection of the implant outward from your chest wall is less," explains Dr. R. Lee Steely, who answered the question of size loss in our "Ask a Surgeon" forum. Going up to a size larger usually helps women achieve their desired size goal.

Get more tips before your breast augmentation consultation

Our breast augmentation forum is a great way to gather tips before your breast augmentation consultation. There, you can converse with real women who've gone through the process. They can tell you about the pitfalls and highlights of their own consults, so you can get the most out of yours.

For further insights, move over to our Q&A forum. Pose your consultation questions. Get answers from board-certified plastic surgeons. It's that simple.

Reviewed By Tom Pousti

On November 14,2018

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