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The Myth of the Double D

When it comes to breast sizes, many of us are used to thinking in terms of the letters A through D. But is this truly a useful metric for comparing bodies, and communicating the changes we’re envisioning? In this blog, we’ll delve into why in the world of cosmetic surgery, cup size isn’t everything. 

The North American method of bra sizing—a cup size (letter) plus a band size (number)— has been around since the 1940s. This two-dimensional sizing system is far from perfect. Most mainstream brands like Victoria’s Secret, La Senza, and Agent Provocateur carry a very limited range of sizes—and not only that, sizing is often inconsistent between brands. This results in frustration for many women who are unable to find a bra that fits them properly, or who are told by sales associates they should be wearing a size the store carries that is seemingly completely at odds with their body.

Another quirk of this system is that cup sizes—particularly A through DD—have made it into common parlance and pop culture, and cup size is often directly associated with perceived volume. Many people aren’t aware that cup size and band size represent a dependent relationship. Cup size is based not on volume alone, but on the difference between the band size and the bust measurement—hence why two women wearing a 30B and a 38B could look completely different.

(If you’re interested in more information on accurate bra sizing, and resources for where to find bras for all shapes and sizes, check out reddit.com/r/ABraThatFits).

So how does this tie into plastic surgery?

When patients see us for breast surgery, whether it’s for an augmentation with implants, fat transfer, a lift or a reduction, they often use cup sizes to communicate the changes they’d like to make to their breasts—e.g. a ‘full B’ or a ‘small C’. 

While this is an understandable starting point, breast surgery is so much more nuanced than cup size alone, and focusing too much on this metric or using it to compare yourself to others can detract from the smooth surgical experience we strive to provide you with. 

The breast surgery plans we create are based on so many different factors, including your overall frame and build, the dimensions of your chest and the way your breasts are positioned, symmetry, existing and desired pole fullness (the roundness of the breast in the upper and lower portions), the degree of skin laxity, the degree of ptosis (sagging) present, and the placement and direction of the nipples. 

When we’re performing an augmentation with implants, there is another host of decisions to make: implant material, shape, volume, projection, placement over or under the muscle, and where the incision will be made. (For more information on these options, read our breast augmentation guide here.)

Each of these implant characteristics can interact differently with your unique body, which is why asking for the same type of implant that your friend got is not a guarantee that you will end up with the same results. Of course, your surgeon will walk you through all of your options and help you to decide.

We can’t stress this enough—each breast surgery is unique! Because of this level of nuance to the human body, performing an operation that enhances its aesthetic appearance while maintaining a natural-looking form is really a combination of art and science.

We sometimes run into issues when it comes to patients seeking input from others and relying on cup size terminology to communicate. For example, a patient may relay to their surgeon that they’d like to be a C cup and settle on an implant size during their consultation, after much consideration and careful planning by their surgeon. They later hear that a friend of theirs is a C, but she doesn’t look the way they’re envisioning—and get worried that they won’t be happy with their results. As we’ve discussed, not only can the same implant look completely different on two different people, so too can the same cup size. Rest assured, your surgeon is taking all of the above factors into account and guiding you towards the best option for your body.

Another point we often hear circulating on online forums is the recommendation to go a size larger than what your surgeon recommends, otherwise you’ll ‘regret it’. While it’s possible that you may want to go larger, bigger isn’t always better, and there’s a limit to the size that your surgeon can work with while still ensuring beautiful results. Implants that are too large for your frame to support can lead to a myriad of problems down the line, including unnatural descension or distortion of the breast. While peers and forums can be a great resource for discussing the decision to have surgery or what to expect from recovery; it’s important not to rely too heavily on non-medical professionals who simply don’t have the level of training to advise you on sizing decisions.

What do we recommend?

A great strategy is to seek out before and after images showing patients with a similar body type to your own, to get a sense of what the potential changes could look like. Our gallery is a great place to start, and you can visit Dr. Somogyi and Dr. Jalil on RealSelf as well. 

We also recommend considering whether you’d like to appear larger than proportional, smaller than proportional, or perfectly proportional, and communicating this to your surgeon during your consultation. You are welcome to bring any images you like with you, and we’ll have even more to go through with you as well. And of course, trust your surgeon! Ask questions, voice your concerns, and choose a surgeon you feel comfortable with. Ultimately, our goal is to provide you with a safe, successful surgical experience and results you’ll be thrilled with for years to come. 

Due to increasing interest in cosmetic surgery, FORM Face + Body has opened additional OR time through September—December 2021. If you are seeking to book surgery, inquire today.

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