As a plastic surgeon, I am frequently asked about breast size, whether I am making breasts larger (a breast augmentation) or smaller (breast reduction).  I’ve been doing this work for over 10 years and happen to have breasts myself, so I have my own take on sizing that I think is worth sharing.

Just yesterday, a woman came to see me to discuss enlarging her breasts.  I asked her what size she thought would be ideal for her, telling her at the time it was a trick question.  She answered that she would like to be a C.

She tried two different sets of implants at her visit, one which made her appear proportional at her hips and her chest, and another that made her breasts look more prominent and fuller than her hips.  She liked the larger implant size more and studied herself in the mirror from several angles.  She smiled and appeared confident.  Then she asked:

What size do you think this would make me?

The honest answer is:  I do not know.  Sizes can vary depending on where a bra is purchased, how someone likes their bras to fit, and who makes the bra.  Also, there is no direct correlation between implant size and cup size:  how much breast tissue someone starts with and how wide their chest is are just two factors that will determine what bra size someone eventually wears.  There are no implants that are A or B or C cups.  For this reason, I tell patients not to worry about what size bra they wear, but to be happy with the way they look.

For this patient, though, I told her I thought the size she liked was likely larger than the C she mentioned as her ideal size when we first talked.  I thought that she may be a D or DD depending on where she shopped for her bras.

In an instant, her face changed from confidence to concern.  The size she had been admiring suddenly seemed to her to be too big.  “I don’t want to be a D,” she said.

What is it about the bra size label that changed this woman’s opinion in an instant?  The look of her chest did not change, just a letter I mentioned as a guess.

In my opinion, the desired goal of a breast enlargement surgery should be to like what you see in the mirror, regardless of what bra size it is.  I tell my patients this frequently.  While I ask about cup sizes to get an idea of the change that someone is looking for, there is no way to promise that an outcome of surgery will fit a certain garment.  For me, I want the women that have surgery with me to be happy with their look and not a letter.

I reassured this woman that, ultimately, she needed to choose an implant that she thought enhanced her body and not be concerned with a letter on a bra.  As she admired herself again in the mirror, I saw that confidence return and a smile appear on her face.  Letting go of the letter was all it took.