"I would like to be a C cup": that is how it almost always starts. But the right implant is not chosen from a cup size. Here is how we actually get there in the consulting room, measurement by measurement, and what makes the difference between a breast that looks operated on and one that simply looks like yours.
"I would like to be a C cup." That is how almost every conversation about breast augmentation begins, and it is understandable: cup size is the only language we are used to when talking about breasts. The trouble is that the number tells a surgeon very little.
Over 35 years of practice as a plastic surgeon I have seen that the most beautiful and longest-lasting results come from a choice built on a person's real measurements. Here I explain how that choice is reached. If instead you are looking for the full picture of the procedure — anaesthesia, incisions, recovery — you will find it in the complete guide to breast augmentation.
In short: an implant is not chosen from a cup size but from your chest measurements, first of all the breast base width. Every implant is defined by four parameters: volume, width, profile and shape. The result looks natural when the implant does not exceed the base and the projection is sustainable for the tissues covering it. During the consultation we measure, try the volume on with sizers and decide together.
Because it is not a surgical measurement. A C cup varies from brand to brand and depends as much on the bra as on the breast. As a rough guide it takes 150-200 cc to go up about one cup size, but it really is rough: the same volume on a narrow chest produces a far more visible increase than on a wide one.
So in the consulting room I ask you to translate the wish into something more precise: how you want the breast to sit in a fitted top, what you dislike today, what result you have in mind. Then I take out the tape measure. This is the approach known in the literature as tissue-based planning: it is your chest and your skin that say which implants can be used, before any wish about volume.
The most important one is the breast base width: how wide your breast is at its root, from one edge to the other. It is an objective figure that cannot be changed, and it defines the space available on your chest. An implant wider than the base has nothing to sit on: it ends up spreading towards the armpit or towards the centre of the chest.
Alongside it I measure the distance between the two breasts, the height of the inframammary fold, the position of the nipple relative to the fold and the asymmetry, which is almost always there. These are the figures that say where the implant can sit and how much room there is to fill the lower pole without forcing it.
Then comes the least visible but decisive part: the quality of the tissues. With a simple manoeuvre I assess the thickness of the cover and the elasticity of the skin. Thick, elastic tissues tolerate larger volumes and hide the implant edges well; thin tissues call for caution, because an implant that is too large shows at the contours and stretches the skin over the years.
Four characteristics. Choosing one means getting all four to agree with your anatomy:
As for which to choose, the answer I give often comes as a surprise: shape is the least decisive of the four parameters. It is width and profile that determine whether the breast will look natural. A round implant with a modest profile, on a properly measured base, gives a more natural result than an anatomical one chosen by eye.
Because a breast is never seen on its own, but within a figure. During the consultation I look at the structure of the chest, the width of the shoulders, the hips and your height: the same 300 cc that look excessive on a petite frame can look almost discreet on a fuller silhouette. Proportion is a ratio, not a number: this is why a friend's cup size is never a good reference.
Your daily life matters too. Someone who runs, swims or trains regularly lives better with moderate volumes and modest profiles, which weigh less on the tissues and get in the way less. I always ask, because it affects satisfaction years later far more than people expect.
Finally there is your own goal, which I always respect: some women mainly want a fuller décolletage in clothes, others want to recover volume lost after a pregnancy. These are different requests that lead to different technical choices: the first works on the profile, the second on the lower pole.
A few visual rules, always the same ones. The upper pole is soft, not bulging; most of the volume sits in the lower pole; the transition between chest and breast is gradual, with no step; and the two breasts are symmetrical but not identical, because in nature they never are.
When a breast does "show", the reason is almost always a wrong choice made earlier:
None of these problems depends on the brand of the implant. They depend on planning, which is why I spend so much of the consultation on measurements.
At our practice choosing the implant is a process, not a decision taken in a hurry:
We start from your goals: what you dislike about your breasts today, what result you have in mind, what clothes you would like to wear. Reference photos are welcome.
Breast examination, measurement of the breast base, the distance between the breasts, the height of the fold and the position of the nipple, with assessment of the tissues and of any asymmetry.
The measurements produce a range of compatible implants: some widths and profiles work on your chest, others do not. This is where the wish meets the anatomy.
You wear sizers in your bra to see the real bulk of the different volumes, including in clothes. Seeing is far more useful than imagining.
Together we define the implant, the incision and the placement plane, with the reasoning behind each choice and the realistic limits of your case.
Before surgery everything is checked again: measurements, pre-operative marking done standing up and final confirmation of the plan.
A good consultation is not there to convince you: it is there to let you choose knowingly. If the measurements show that the volume you want is not sustainable for your tissues, I say so plainly and offer you the best alternative. It is the surest way to be happy not one month later, but ten years later.
Arriving prepared makes the visit far more productive. It helps to bring photos of results you like — and, if you have them, of results you dislike, which often say more — to know what clothes you would like to wear with your new breasts, and to have your sporting lifestyle in mind. Any breast imaging you have already had is useful too.
And these are the questions always worth asking your surgeon, me or anyone else:
If the answers come with figures, measurements and reasons rather than a cup size, you are in the right place.
Drag the slider over the image to compare before and after. These are real cases operated on by Prof. Borriello, with different implant choices because the starting anatomy was different.
Two before/after comparisons of real cases are shown here in the article.
Photos of real patients published with consent. Results are individual and vary from person to person.
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It starts from your chest measurements, not from a cup size. The breast base width defines which implants can sit on your breast; the profile sets how much projection your tissues can sustain. Within the compatible range the volume is chosen according to your goals, trying it on with sizers in your bra to see the real bulk before deciding.
There is no reliable conversion. As a rough guide it takes 150-200 cc to go up about one cup size, but the result depends on chest width: the same volume on a narrow base produces a far more visible increase than on a wide one. That is why cup size is not a basis for the decision, whereas measurements and trying sizers are.
They are trial implants worn inside your bra during the consultation. They show the real bulk of the different volumes on your body, including under a fitted top, and how noticeable an increase will actually be. They are the most concrete way to make the number in cubic centimetres meet the image you have in mind, before any decision is taken.
Partly: with sizers and by comparing your case with similar cases already operated on. It is a realistic forecast, not a photograph of the future: the final result also depends on how your tissues adapt to the implant over the following months. Be wary of anyone promising an exact match with a simulation.
With three rules: an implant that does not exceed the breast base, a projection sustainable for the thickness of the tissues, and a distribution of volume that favours the lower pole, leaving the upper one soft. To these add respect for the slight natural asymmetry between the two breasts. It is a matter of planning, more than of brand or model.
Yes, and it is very useful: images make concrete a wish that is hard to put into words. They need to be read together, though, because another person's breast comes from a different anatomy: what can be reproduced is the style of the result, not an exact copy.
We talk it through, with the figures in front of us. Sometimes there is room and it is simply a matter of a different profile; other times the volume you want exceeds what your breast base and your tissues can sustain, and in that case I tell you. It is not excessive caution: an implant that is too large for its tissues causes problems that show years later, not in the first months.
As long as it takes to do it properly: breast examination, full measurements, tissue assessment, trying volumes with sizers and agreeing the plan together. Bring any breast imaging you have already had, any reference photos and, if you can, a fitted garment to judge the bulk in clothes. It can be booked from the website or by phone at Prof. Borriello's practice in Naples.
The difference between a breast that looks operated on and one that simply looks like yours lies neither in the brand of the implant nor in the number of cubic centimetres: it lies in the consistency between the implant chosen, your measurements and your tissues. It is precision work that begins with a tape measure and a frank conversation about goals.
If you are considering breast augmentation and want to understand which implants genuinely suit you, book a consultation at our practice in Naples: we take the measurements, try the volumes together and build a tailored plan, with clear and realistic goals.
This content is intended for informational and educational purposes only. It does not in any way replace professional medical advice, diagnosis, or treatment. For any medical questions or concerns, it is essential to consult your physician or a qualified specialist.
Find out during a dedicated consultation with Prof. Borriello: we take your measurements, assess your tissues, try the volumes on with sizers and build a tailored plan for your case.