Is Bigger Always Better? Going from an A-cup to D-cup

We live in a society that tells us that bigger is always better. We should always strive to have more of a good thing. This can very clearly be seen among women who opt for breast augmentation. Their stated goal is to have bigger, fuller breasts that are at least one-cup size larger than their natural breasts. While in most cases, this goal is not difficult to achieve, a problem arises when women with very small breasts want them enlarged more than two cup sizes, such as from an A cup to a D cup. There may be structural issues regarding the size of the chest wall and the amount of available tissue, as well as with actual sizing.

Implant Profile

The breast implant profile, or the circumference and height of the breast implant, can be a key factor in how much augmentation can actually be achieved. Implants that have a wider circumference and a lower height are known as low profile implants. Those that have a greater height than circumference are known as high profile implants.

As a general rule, the best way to size implant profile is based on the width of the chest wall. Those patients with a wider chest will likely want to opt for a lower profile implant, so that the breasts do not appear to be set too far apart on the chest wall. Conversely, patients with a narrower chest will want to opt for a higher profile implant in order to avoid the “uniboob” appearance of having the implants too close to each other.

Support Structure for Implants

Patients with smaller breasts are more likely to also have very narrow chest walls. This makes it much more difficult to use high profile implants because there may simply not be enough breast tissue to properly support implants that are too large. The end result may be implants that show underneath the skin or shift downward (“bottoming out”) or to one side or the other. This will be particularly noticeable for implants placed in front of the pectoral muscle.

There may also not be enough pectoral muscle to provide a proper pocket for implants that are placed behind the muscle wall. If that is the case, there is a high risk of capsular contracture, which is when excess scar tissue forms around the pocket holding the implant, causing it to shift out of place.

Size Matters

The other main problem with bringing a patient from an A cup to a D cup is that the entire concept of breast sizing by cup is inaccurate. Breast sizing by cup was first introduced in the 1930s. Due to social conventions of the time, no actual measurements of breasts were taken in creating this sizing system. As a result, cup sizing is not an exact science, and can differ between bra manufacturers. This makes the notion of sizing implants by bra cup size even more inaccurate.

The key is not to think of breast augmentation in terms of cup sizes, but rather in terms of which profile implant will best suit the patient, given anatomical considerations. Implants that are selected for each patient’s individual needs will be far more likely to give the desired appearance than simply picking the largest implants available.

To schedule a breast augmentation consultation, contact Jefferson Plastic Surgery.