If I Were Getting Breast Implants, These Are 5 Decisions I’d Never Make
A plastic surgeon’s perspective on choosing breast implants—and why there’s much more to breast augmentation than cup size
When patients come to see me for a breast augmentation consultation, one of the first things they often want to talk about is size.
“What cup size will I be?”
“How many CCs should I get?”
“My friend has 400cc implants—would those look good on me?”
These are reasonable questions. But after years of performing breast augmentation, I can tell you that choosing an implant is much more nuanced than picking a number.
If I were getting breast implants myself, there are five decisions I would never make.
1. I Wouldn't Choose My Implant Based on Cup Size or CCs Alone
One of the biggest misconceptions about breast augmentation is that a certain implant volume creates a particular breast size or appearance.
It doesn't.
A 400cc implant can look dramatically different on two different women.
Why? Because the final result depends on much more than implant volume. I consider factors including:
Height and overall body proportions
Chest and breast width
Amount of existing breast tissue
Skin quality and elasticity
Breast shape and asymmetry
Implant profile and dimensions
Implant placement
Even bra cup size isn't a particularly precise measurement. Sizing varies among bra manufacturers, and two women wearing the same cup size may have very different breast dimensions.
That's why I don't start with “What CC do you want?”
I start with “What do you want your breasts to look like?”
Then we work backward from that goal and determine what implant dimensions and volume make sense for your anatomy.
2. I Wouldn't Expect an Implant to Replace a Breast Lift
This is another conversation I have frequently.
A woman may come in wanting more upper breast fullness but also have significant breast sagging, or ptosis. She hopes that placing a sufficiently large implant will “fill everything back up” and avoid the scars associated with a breast lift.
Unfortunately, that's not always how it works.
Breast implants add volume. Breast lifts reposition and reshape the breast.
If the nipple and breast tissue have descended significantly, simply adding an implant may create a larger breast that still sags.
Depending on your anatomy and goals, you may need:
An implant alone if the primary problem is loss of volume.
A breast lift alone if you have adequate breast volume but want to improve shape and position.
An implant plus a lift if you need both additional volume and significant reshaping.
Trying to avoid a necessary lift by choosing a larger implant can sometimes create exactly the opposite of the long-term result you're hoping for.
3. I Wouldn't Choose the Biggest Implant My Body Can Hold
There is an important difference between:
“Can this implant fit?”
and
“Is this implant appropriate for my tissues?”
Just because your chest can physically accommodate a large implant doesn't mean your skin and breast tissue will support it well for years.
Breast implants have weight.
The larger and heavier the implant, the more stress it can place on the tissues supporting it. Over time, an implant that overwhelms those tissues may contribute to problems such as stretching, implant visibility, rippling, bottoming out, and recurrent drooping.
This doesn't mean large implants are inherently bad. Some women have the anatomy to support larger implants beautifully.
But bigger isn't automatically better.
My goal is to choose an implant that provides the look you want while respecting the limitations of your anatomy and considering what that breast may look like not only next year—but years from now.
4. I Wouldn't Expect Someone Else's Results on My Body
I actually like when patients bring inspiration photos to their consultations.
They help me understand what you mean when you say things like:
“I want natural.”
“I want upper-pole fullness.”
“I don't want to look too big.”
Those descriptions mean different things to different people, so photographs can be extremely helpful.
But inspiration photos are communication tools, not blueprints.
If you show me a photograph of a result you love, I can identify characteristics of that result and discuss whether they're realistic for you.
But I cannot give you someone else's breasts.
Their starting anatomy may be completely different—their chest width, breast tissue, nipple position, skin elasticity, rib cage, height, and proportions all influence their result.
Good breast augmentation isn't about reproducing a photograph.
It's about creating the best version of that aesthetic for your anatomy.
5. I Wouldn't Panic About the “Replace Them Every 10 Years” Rule
I still hear this frequently:
“Don't breast implants have to be replaced every 10 years?”
Not automatically.
Breast implants are not lifetime devices, and the likelihood of needing another breast operation increases the longer you have them. But that doesn't mean an implant suddenly expires on its tenth birthday.
Some women need revision surgery earlier because of rupture, capsular contracture, implant malposition, changes in their breast tissue, or simply because their aesthetic goals change.
Other women may have implants that continue to look and feel good well beyond 10 years.
The decision to replace an implant should be individualized and based on factors such as your symptoms, physical examination, appropriate imaging, the age and type of your implants, your goals, and your surgeon's recommendations.
In other words:
Know how old your implants are. Don't assume their tenth birthday automatically means another operation.
So How Should You Choose a Breast Implant?
Breast augmentation is so much more nuanced than:
“What cup size do you want?”
The implant itself is only one part of the equation.
A thoughtful breast augmentation considers your anatomy, the quality of your tissues, your lifestyle, your aesthetic goals, and how today's decision may affect your breasts years from now.
That's why I view implant selection as a process we do together.
You tell me what you hope to achieve.
I help you understand what your anatomy can realistically support.
And together, we select an implant and surgical plan designed specifically for you.
Want to Learn More About Implant Selection?
I've written a more detailed guide covering implant size, implant type, profile, textured implants, implant placement above or below the muscle, and other factors that go into planning breast augmentation:
Considering Breast Augmentation?
If you're considering breast augmentation, you don't need to arrive at your consultation knowing your cup size, implant volume, or profile.
That's what the consultation is for.
Bring photographs of results you like. Tell me what you want to change—and what you don't want to change. We'll evaluate your anatomy, discuss the tradeoffs of your different options, and develop a plan that fits your body rather than trying to fit your body to an implant.
Because the best breast augmentation isn't about choosing the “perfect” implant.
It's about choosing the right implant for you.
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