An important issue when deciding to have a breast augmentation is choosing a breast implant size. There are many factors that influence the choice of the appropriate size breast implant for a particular woman. Many women have a friend who has already had a breast augmentation, and think that they want the same implant size that their friend has, based on what their friend’s breasts look like. The problem with this approach is that the final size of the breast is a combination of the implant PLUS the amount of tissue that one is starting with. If two different women are starting with two different sized breasts, than placing the same size implant in both of them clearly will result in different sized breasts postoperatively. There are other important anatomical issues to consider which vary considerably from one woman to the next. One is the starting volume of skin. A woman with more breast skin can accommodate a larger implant than a woman with less breast skin. Another big issue is tissue quality. A woman with thinner tissue will tolerate much less expansion in size than a woman with thicker tissue. The larger the implant, the more the tissue is stretched and thinned, resulting in less coverage of the implant and a less natural result. Choosing breast implant size also involves various measurements that are taken of the breast during a breast augmentation consultation. These measurements vary greatly from woman to woman, and are important in selecting an appropriate size and profile of breast implant. At times, some women prefer to have a larger implant placed than what may be ideal for her anatomy, accepting the trade-off of a larger size for a less natural feel. A consultation with an experienced board certified plastic surgeon, certified by the American Board of Plastic Surgery, can analyze all of these issues and produce the best possible outcome after a breast augmentation.