"Are these breast implants too big, too small, or just right?" - Goldilocks

We're all familiar with the tale of Goldilocks and her quest to find the perfect porridge – not too hot, not too cold, but just right. The process of breast implant sizing can feel very similar. While many women are happy with their breast augmentation results, the fear of going too big or too small is a common concern. According to a nationwide study published in 2021, 8% of 552 breast augmentation patients had a re-operation within 10 years to change their implant size [1]. 

We've interviewed dozens of breast augmentation patients who feel they either went too big, too small, or got it just right. Their stories highlight the nuanced decision-making process of breast implant size. Here is what they wish they knew and what Board Certified Plastic Surgeon, Dr. Aldona Spiegel,  says you should consider as you start your breast augmentation journey with your plastic surgeon. 

The Benefits of Getting the Implant Size Right

When you take the time to carefully consider your options and work closely with your plastic surgeon to select the ideal implant size, the benefits can be transformative:

1. Increased Confidence: Achieving your desired breast size can greatly improve your self-esteem and body image. When your breasts are in proportion to your body and align with your vision, you may feel more comfortable and confident in your appearance.
2. IImproved Fit of Clothing: With the right implant size, you'll likely find that clothes fit better and more comfortably. You won't have to worry about tops being too tight or loose in the chest area, and you can enjoy a wider range of fashion options that complement your new figure.
3. Enhanced Natural Appearance: Choosing an implant size that suits your body frame can create a more natural-looking enhancement. The goal is to achieve a balanced, harmonious appearance that doesn't draw undue attention to your breasts but rather enhances your overall proportions.
4. Minimized Complications: Selecting an implant size that is appropriate for your body and working with a skilled plastic surgeon may reduce the risk of complications. A well-proportioned implant size puts less strain on your tissues and helps maintain the long-term health of your breasts.
5. Long-term Satisfaction: Getting the implant size right from the start can help you avoid the need for revision surgeries in the future. Revision procedures can be more complex, costly, and emotionally taxing. By making an informed decision initially, you're more likely to be satisfied with your results for years to come.

One woman we interviewed, Rachel, underwent a breast augmentation and felt that her surgeon got the size just right. She shares, "I feel incredibly lucky that my surgeons chose implants that complement my frame perfectly. The results have been fantastic, and I couldn't be happier." Rachel's story highlights the importance of working closely with a skilled surgeon and effectively communicating breast goals to achieve the ideal implant size. 

‍The Pitfalls of Going Too Small

Choosing an implant size that is too small can lead to disappointment and dissatisfaction with the results. While there are some benefits to opting for a more conservative size, it's essential to understand the potential drawbacks to ensure you make an informed decision.

1. Unachieved confidence: The main reason women get breast aug is to gain self-confidence and body-confidence. With smaller implants, this may not be achieved leading to disappointment
2. Underwhelming Results: Smaller implants may not provide the significant change some women are seeking, leading to frustration if the outcomes don't match their vision. 
3. Lack of Desired Cleavage: Smaller implants may fail to provide the desired cleavage or fullness at the top of the breasts, which is a common aesthetic goal for many women seeking breast augmentation.
4. Difficulty Achieving Body Balance: For patients with wider hips, smaller implants may not create the desired hourglass figure by balancing the upper and lower body proportions.
5. Clothing Challenges: Some patients may find that smaller implants don't fill out clothing or swimwear as they had hoped, affecting their wardrobe choices and limiting their options.
6. Financial Impact with  Revision Surgery: Some women choose to get a revision surgery to increase the implant size which can have a significant financial impact on patients.

Two women we interviewed shared their experiences with going too small. These stories demonstrate the unique perspectives and trade-offs that come with choosing smaller implants. Some women, like Sydney, prioritize their active lifestyles and are content with their decision, even if they occasionally wish for a slightly larger size.

"While part of me wishes I had gone slightly bigger, I'm ultimately relieved I chose a size that doesn't hinder my workout regimen. It's a big part of who I am, and I'm glad my implants complement my lifestyle rather than complicate it. When it's time for a replacement, I might opt for a bit more volume, but for now, I'm content knowing I made a choice that supports my health and happiness." - Sydney

Other women, like Kellie, may initially feel that their implants are too small, but come to appreciate the natural appearance, especially after significant life events such as pregnancy.

"I started as an A-cup and ended up with a C, which looked smaller on my frame than I expected. After pregnancy, my breasts grew significantly. Post-pregnancy, I lost some volume and they ended up complimenting my body perfectly." - Kellie

It's important to note that while some women can live with the decision of going too small, others may feel strongly enough about their dissatisfaction that they decide to pay for a revision surgery to increase size immediately. Ultimately, the decision to undergo an additional revision surgery is a personal one that should be made after careful consideration and consultation with a trusted plastic surgeon.

The Risks and Challenges of Going Too Big

On the other end of the spectrum, selecting implants that are too large for your frame can come with its own set of challenges. It's crucial to be aware of the potential physical, emotional, and long-term implications of going too big and to discuss these with a board certified plastic surgeon. 

1. Clothing Difficulties: Finding clothes that fit well can become challenging with overly large implants, often leading to a disproportionate emphasis on the chest area.
2. Emotional Impact: Larger implants might make some women feel more noticed and uncomfortable, leading to self-consciousness. Drastic changes in appearance can also result in lasting regret or doubts.
3. Physical Discomfort: Some women report that larger implants can hinder comfort in daily activities like sleeping or exercising. The added weight may cause back, neck, and shoulder pain, and exacerbate posture problems.
4. Long-term Aesthetic Concerns: Over time, weight gain, pregnancy, and aging may exaggerate the appearance of large implants, disrupting body harmony. Large implants may also hasten the effects of aging and gravity on breast tissue, leading to earlier sagging.
5. Increased Risk of Complications: Implants that are too large are associated with a higher risk of complications such as: implant rupture [2], postoperative asymmetries [2], rippling, and malposition. These complications may require revision surgery to correct. 
6. Complex Revision Surgery: Downsizing implants may be more complex, requiring surgical modification of the implant pocket and potential breast lift to remove excess skin. Scar tissue from previous surgeries may further complicate the revision process.

Two women we interviewed, Nicole and Megan, shared their experiences with going too big and the trade-offs they faced. Nicole felt she came out of her surgery with implants that seemed much larger than she expected. That said, for many years, she was very happy with her new breast size. However, that changed over time as she experienced weight gain and the effects of gravity.

"My larger breasts made clothing uncomfortable and caused neck pain. I also felt that I looked top heavy. Eventually, I decided to get an explant procedure to remove my implants." - Nicole

Megan, who had two breast augmentation procedures, one where she went too small and then one where she felt she went too big, shares her perspective:

"I love the way my larger breasts look now, but I do have to deal with some discomfort from time to time. It's a trade-off I've learned to live with, but I wish I had found a size that balanced my aesthetic goals with my physical comfort." - Megan

These stories highlight the importance of considering the long-term implications of larger implants and the potential need for revision surgery. While some women, like Megan, are willing to accept the trade-offs that come with larger implants, others, like Nicole, may find that the discomfort and aesthetic concerns become too significant to bear over time.

It's crucial for women considering breast augmentation to think about how their implants will look and feel not just immediately after surgery, but also years down the line. Open communication with a skilled plastic surgeon can help women make informed decisions that take into account both their short-term desires and long-term well-being.

How Auggie Helps with Size Selection

Choosing the right implant size can be a daunting task, but with Auggie's at-home breast implant sizes the decision-making process is more tangible. These realistic breast implant sizers allow women to try on different implant sizes in the comfort of their own homes, providing a more accurate representation of how each size will look and feel on their unique body shape.

By offering a tangible way to explore implant sizes outside of the surgeon's office, Auggie empowers women to make more informed decisions and communicate their preferences effectively with their plastic surgeons. This collaborative approach helps align expectations, reduce anxiety, and increase the likelihood of achieving satisfactory results that balance aesthetic goals with practical considerations.

“It's a big decision, and you're putting a lot of trust in your surgeon's hands. Even though I communicated my goals clearly, there's always that lingering concern of ending up with implants that are too big or too small." - Rachel

Tools like Auggie's at-home sizers can help alleviate some of these concerns by allowing women to gain a better understanding of their options and make choices that prioritize their long-term satisfaction and well-being.

Selecting the right breast implant size is a highly personal and complex decision that requires careful consideration of individual goals, body proportions, and lifestyle factors. By learning from the experiences of others, maintaining open communication with a skilled plastic surgeon, and  utilizing tools like Auggie's at-home sizers, women can navigate this journey with greater confidence and increase their chances of achieving the best possible outcome.

References:

[1] Caplin, D. A., Calobrace, M. B., Wixtrom, R. N., Estes, M. M., & Canady, J. W. (2021). MemoryGel Breast Implants: Final Safety and Efficacy Results after 10 Years of Follow-Up. Plastic and reconstructive surgery, 147(3), 556–566. https://doi.org/10.1097/PRS.0000000000007635

[2] Medor, M. C., Bouhadana, G., Churchill, I. F., Hemmerling, T., Bonapace-Potvin, M., Papanastasiou, C., Mussie, A., Borsuk, D. E., & Papanastasiou, V. W. (2023). How Big Is Too Big? Exploring the Relationship between Breast Implant Volume and Postoperative Complication Rates in Primary Breast Augmentations. Plastic and reconstructive surgery. Global open, 11(3), e4843. https://doi.org/10.1097/GOX.0000000000004843