Breast implant size is one of the most important decisions in breast implant surgery. Because of this, a good breast augmentation mammoplasty surgeon will take several approaches to help the patient make an informed decision based on their anatomy, personal preferences and the appearance they wis h to achieve. In a recent survey, over 50% of patients undergoing breast augmentation mammoplasty stated an average to full C-cup was their desired postoperative goal. D-cup was the second most popular request at 35%. Small C-cup is the third commonest followed by full-D and Double D cups. The choice will be impacted by the elasticity of a patient’s skin envelope, chest wall diameter and implant dimensions but most importantly preexisting breast volume. For these reasons, Dr Tavakoli begins by showing the patient numerous photos of actual patients who have had breast augmentation mammoplasty surgery – before and after breast implants photos. By finding someone who has a similar preoperative appearance and evaluating their results with the size of implant they chose, the patient can then get an idea of what her chosen implants can achieve and increase or decrease the implant size according to her wishes. Dr Tavakoli will also measure the patient’s breast and chest shape, paying particular attention to the base and projection of the breasts. This gives us an idea of what size implant will help achieve the patient’s desired size postoperatively. As breast size increases, so does the diameter of the breast implants. In most cases, there is an implant that will b e a suitable match for the diameter of the patient’s natural breast tissue, and Dr Tavakoli finds this is a good starting point for discussion. Choosing breast implants smaller than the patient’s natural breast shape will not provide the proper cleavage and shape following the procedure. Similarly, choosing breast implants too large for the patient’s natural chest shape is more likely to give an unnatural appearance. It is noteworthy that very large implants can create more issues and future complications such as stretch marks, implant migration and symmastia. Unfortunately, breast implants do not come in cup sizes. Rather, they are categorized by the volume of gel that they are designed to hold. There are several reasons for this. First, the final cup size will be partially determined by the preoperative breast size, and every patient is different in this regard. Second, a C-cup from one bra manufacturer is not necessarily the same as a C-cup from another manufacturer. Although every woman is built differently and bras are not manufactured to a set standard, it can be expected that a B-cup implant size is approximately 250g (cc) and a C-cup is 330cc in a woman of average height and average build. That number will be higher if the woman is tall or has broad shoulders. Similarly, if the patient is shorter than average or has a narrower chest, that number can be expected to be slightly lower. Although a desire for a certain cup size is helpful in guiding the patient in the selection of the proper breast implants, Dr Tavakoli finds it is more helpful to focus on the desired shape and appearance th at the patient wishes to achieve.