To determine the size of the implants, I have patients purchase the bra they want to fit into after the operation. It should be a rigid full-cup bra. In the exam room, I place progressively larger implants into the bra and have the patient look at herself in the mirror. Eventually, she will like the size. I coach and advise her if she is choosing too large a size, but ultimately the decision is hers.
Despite the plastic surgeons on reality television shows, bigger is not better. There is no question that the long-term aesthetic result from an augmentation is worse with larger implants. Problems such as droop, abnormal shape, and the visibility of wrinkles increase with larger implants. I strongly believe that women should have average-sized breasts -- not so large that they are stared at or that they begin to have the physical problems associated with excessively large breasts.
Find out more about this book:Straight Talk about Cosmetic Surgery (Yale University Press Health & Wellness)