The sizing process, during a consultation, is a compromise between your desired breast size and your anatomy. In other words, there may be situations where someone wants a very large or very small breast - this may not be possible because of the breast size that you have. Most women will also discuss cup size during implant sizing. It is important to understand that breast size is not really related to cup size per se. (This is really something that was made up by the bra manufacturers). The cup size is not a good way to determine the breast size - there is no way to determine what cup size implants will give each individual woman. For example, when a woman purchases a bra from one store it may be different from a bra at another store - the cup size may be different. If you go to Target you may buy a C-cup bra that fits. Then you may go to Victoria’s Secret to buy a D-cup bra that fits. The actual bra size might be the same, but the label changes. Getting the idea of cup size out of the picture is important. The actual implant size, along with your desire of the size, will be determined in a more succinct way during a consultation. The sizing process considers the dimensions of the breast, the skin consistency, and the tissue consistency. If two breasts have the same diameter but one is a very small tight breast, and the other is a larger looser breast, there is a potential of placing more volume in the looser breast. Some plastic surgeons actually measure the breast diameter. Many surgeons, like myself, compare the breast diameter to a sizer or actual implant during the consultation. Ideally the implant diameter stays within the diameter of the breast. If the diameter is larger than the breast then there may be breast distortion. We often see women on television shows, or in the media with extremely large implants; these can be problematic and can cause serious problems. On the other side of the coin, an implant that is too small will not fill the envelope of breast tissue and also cause problems with the tissue. There is a balance between the desire for size and the anatomy that you have. Finally, the sizer is placed into a bra. You can look at the size in the mirror and get an idea of the sizes acceptable for your anatomy. In this way, a fairly reliable idea of your appearance after surgery can be achieved! (Although, it is important to note, this process is not an exact science).