When a patient comes to me for a breast augmentation consult, we have to decide what size implant will achieve the patient’s desired results.  One of the first decisions a patient must decide is whether she wants a natural appearing breast or an augmented appearing breast.  More specifically does the patient want to have natural vs augmented appearing breast in daily clothing vs evening gowns vs swimsuits.  If the patient desires a natural appearing breast, then we have to choose an implant with a diameter that is less than or equal to the width of the breast.  We can alter the projection or profile of the implant to achieve a volume that the patient desires and maintain a natural appearing breast.  If the patient wants an augmented appearing breast, then we need to choose an implant that is larger than the width of the breast.  We also have patients place anatomic sizers in their bras during the consultation to allow the patient to chose their implant size.  By listening carefully to my patients, I am able to customize their breast augmentation to achieve the size and shape breast that they desire.