A breast reduction involves the removal of a significant amount of breast tissue. Intuitively, it would seem that with less volume, there would be less tissue available to degenerate into a cancer in a particular individual. This indeed has been borne out in through medical research. The decreased risk of developing breast cancer following a breast reduction has been documented in several medical studies as being somewhere between 28% and 50%. The women who benefitted from this lowered risk were over the age of 40 at the time of their surgery. To date, no discernible affect was identified in women under 40 years old.
This statistical finding is great news. It is one more positive piece of information for women considering a breast reduction. For women who have an increased risk of developing breast cancer and are considering prophylactic breast tissue removal, this is not an appropriate treatment as a significant amount of breast tissue remains. A procedure such as a subcutaneous mastectomy or total mastectomy would be more appropriate.

The number one issue facing women when electing to undergo a breast augmentation is selecting the proper sized breast implant. This is a truly a much more complex problem than one would think. You know that you want to be larger but how large? Do you want to be a “C”? A “small D”? A “full C”? Do you want to be proportionate, a little larger than proportionate or very large?

Unfortunately, these are all very subjective, personal and not standardized. What may be proportionate for one person would be way too small for another. A large “C” for one woman may be another’s “D”. Overly large breasts to one woman may be considered balanced to another. Further compounding the confusion is that there is no standardization of cup sizes among bra manufacturers. One company’s “C” bra may be identical in fit with another company’s “D” sized bra.

In my experience, I have found some useful approaches to assist my patients in better determining the size that they are seeking. Trying on a variety of implants in the office can provide some facsimile of a three dimensional result although the true shape and size will be different. Judging their responses to various elements then allows me to better ascertain what they desire. They are also shown photographs of a diversity of patients with varying cup sizes. Many patients bring in pictures of breast shapes and sizes that they like from the internet or magazines which can further help. However, there are limitations due to clothing, air-brushing, perspective and the two dimensionality of the pictures.

Combining all this information and input along with some intuition, I can determine reasonably well what my patient is looking for. During surgery, all this information assists me in making the final decision on the most desirable implant size. If there is any question about the size, I will elect to go larger rather than smaller. This approach is usually makes everyone happy.

These a a few different sizes of Silicone implants