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“How does Dr .Brown pick my implant? The one he suggested sounds huge compared to my friends, won’t I look ridiculous?”


Once you have made the decision to have a breast augmentation, the most important choice often relates to the size of the implant. We often have a situation where Dr. Brown has recommended a certain size and style of implant only for you to discuss this choice with a friend, who tells you it is a dreadful mistake and that they know better!


In this situation the best advice we can give you is this: don’t discuss your implant volumes with people who offer an unqualified opinion, and return to discuss your concerns with Dr. Brown and his staff, who has been dealing with these issues for 20 years.


When Dr. Brown undertakes his initial clinical examination, he records a number of measurements concerning the dimensions of your breast. Importantly he measures the width of the breast, how much soft tissue covers the breast and the amount of droop. All of these measurements assist in providing options that would fit your anatomy, after which you can choose which implant feels appropriate for you. Dr. Brown’s clinical nurse educators Tracey and Joanne are very experienced is assisting patients to make these decisions, and it is not unusual for patients to visit several times before making their choice.


Breast width


The base width of the implant should match the width of the breast, after the soft tissue covering has been considered. Pick an implant that is too narrow, and the breasts will look widely spaced; pick one that is too wide, and your figure will appear top heavy. This measurement alone will dictate to a very great degree the volume of breast implant that can be used.


Implant profile


Implants have different degrees of “steepness” or profiles, varying from very flat to quite ball-like.













We need to assist you in choosing the correct profile for the suggested breast width. If you think of an implant as a pole in a circus tent, the higher the pole, the more lift will occur, and the greater the shape of the tent or breast.









                      LOW PROFILE                                                                            HIGH PROFILE

Often patients who have had children have a degree of droop in their breast, and often picking a higher profile implant will produce sufficient lift to produce a pleasing breast shape without having to resort to further surgery.


Another consideration when choosing a profile is the amount of soft tissue that covers the breast. I want you to imagine that an implant is a golf ball. If you place a golf ball under a sheet, it will have a very obvious appearance, with a very distinct junction where it sits on the bed. Now imagine that the same golf ball is placed under a doona. Obviously it will look very different, and it will hardly be visible at all.



Depending on the “look” you are trying to achieve, Dr. Brown will make a suggestion as to which profile might be appropriate for you.


We also look at your overall body shape, paying particular attention to the ratio of shoulders to bust to hips to waist. The aim is to produce a silhouette that is “in proportion”.


The process of sizing is not an exact science, and whilst guidance can be obtained from the measurements, there is a degree of judgement borne from experience that is required. However, it should be possible to examine the relationship between our sizing system and patient satisfaction with their surgical outcome. Consequently, earlier this year Dr. Brown published a large statistical study in Aesthetic Plastic Surgery Journal, which looks at whether or not patients are happy with the choices he assists then in making, and tries to identify groups of individuals who have specific issues relating to breast implant sizing.



Dr. Brown has demonstrated that for his breast augmentation patients, only 3.4% considered that there implants were too large. All these patients were classified as clinically underweight, with BMI less than 19. 20% of patients thought that their implants were too small, and the remaining 76% were happy with the choices that they had made. What does that mean for you? If you are not underweight, and you take on board our advice, you have a very high chance of being happy with the implant size that you have picked. If in doubt about your choice, pick the bigger of the suggested implants, as statistically it is very unlikely you will regret it. One in five women who choose a smaller implant in the range that we suggest, subsequently return and tell us that they wish they had chose the larger implant. This is particularly true for patients with broad breasts (greater than 13 cm wide), as our data suggests that they are 9 times more likely to wish they had picked the larger size!


One of the commonest fears is that patients worry they will look to busty; however the study demonstrates that the commonest outcome is that they don’t feel quite busty enough.


Bra sizes


One last comment about bra sizes – they don’t exist! Each manufacturer has their own system of sizing bras, and there is no international standard sizing system as there is for shoes. Dr. Brown does not, and cannot guarantee a particular bra size, and strongly believes that it is irrelevant. Provided you are happy with your figure, what does the letter on the bra label matter? It would be like going to an open home clutching a number six and telling the real estate agent that you “need one of these”. As long as you are happy with your figure, finding clothes to fit you properly is a secondary issue. If your figure is in proportion, it should be straight forward and present little difficulty. Dr. Brown suggests that you don’t buy bras until at least 6 weeks after your surgery, as his measurements have demonstrated that size and shape can continue to alter for that length of time following surgery.


So, in response to the question “Why are my implants so much bigger than my friends?” the answer is, because you are different from your friend. And will you look ridiculous? Our peer reviewed and published data suggests that will not happen, providing you take advice from Mr Brown and his nurse educators Tracey and Joanne when choosing your breast implant size.


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