Average One-Cup Size Decrease Reflects Women's True Cup Size

PHILADELPHIA — After undergoing breast lift surgery (mastopexy), women may find themselves wearing a smaller bra—with an average decrease of one bra cup size, reports a study in the July issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).

But the difference reflects the effects of the breast lift itself, rather than a true reduction in breast size, according to the study by Dr. Katie Elizabeth Weichman of New York University and colleagues. They believe their results have important implications for talking to patients about the expected results after breast lift surgery.

After Breasts Are Lifted, Cup Size Goes Down

Mastopexy is a popular cosmetic surgery procedure, performed in nearly 90,000 US women in 2012, according to ASPS statistics. Breast lift surgery restores a more youthful and lifted appearance in women with sagging (ptosis) of the breasts due to aging, pregnancy and breastfeeding, etc.

The researchers performed a follow-up survey of 20 women who underwent mastopexy at an average age of 47 years. All patients underwent breast-lifting only—that is, with no significant breast reduction or augmentation. Five years later, the women were asked about their bra cup size before versus after breast lift surgery. Weight change and other factors that might affect bra fit were evaluated as well.

The women reported an average decrease of approximately one cup size—for example, from a D to a C cup. All of the women reported no change in bra manufacturer; that's an important consideration, as sizing can differ between brands.

One patient reported a substantial increase in cup size, but this seemed to be related to hormone therapy and weight gain. All of the women said they were satisfied with the results of their breast lift surgery.

After Mastopexy, Bra Fit Is Closer to 'True' Cup Size

So if surgery only lifted the breasts rather without changing their size, why did cup size decrease? The answer has to do with correct bra fit and patient comfort, Dr. Weichman and coauthors believe. "It is well known that most women do not wear the correct bra size," they write.

Because of excess skin and soft tissue, women with breast ptosis may be more comfortable with a looser-fitting bra. The researchers write, "It is our contention that ptotic breast fills out a larger (than actual) brassiere cup size." After their breasts have been lifted, women may choose a smaller cup size for reasons of comfort.

The findings have important implications for setting patient expectations—especially because most patients considering mastopexy want to improve the shape of their breasts, without changing the size. "Consequently, conveying to them at the initial visit, that lifting alone will result in a smaller cup size avoids the potential for over reducing and patient dissatisfaction," Dr. Weichman and coauthors write.

"We encourage patients to consider their true preoperative cup size to be smaller than what they currently wear," the authors add. They suggest a technique that the plastic surgeon can use—simply elevating the breast with the thumb and forefinger—to give women an idea of the expected results after mastopexy, as well as showing them their true bra cup size.

Dr. Weichman and colleagues note that their patients were on average of low-normal body weight and wore at least a C cup size before surgery. The findings therefore may not apply to heavier women or those with smaller breasts.

Plastic and Reconstructive Surgery is published by Lippincott Williams & Wilkins, part of Wolters Kluwer Health.

About Plastic and Reconstructive Surgery

For more than 60 years, Plastic and Reconstructive Surgery (PRS)® has been the one consistently excellent reference for every specialist who uses plastic surgery techniques or works in conjunction with a plastic surgeon. The official journal of the American Society of Plastic Surgeons, PRS brings subscribers up-to-the-minute reports on the latest techniques and follow-up for all areas of plastic and reconstructive surgery, including breast reconstruction, experimental studies, maxillofacial reconstruction, hand and microsurgery, burn repair, and cosmetic surgery, as well as news on medico-legal issues.

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About ASPS

The American Society of Plastic Surgeons (ASPS) is the world's largest organization of board-certified plastic surgeons. Representing more than 7,000 Member Surgeons, the Society is recognized as a leading authority and information source on aesthetic and reconstructive plastic surgery. ASPS comprises more than 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the Society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada. ASPS advances quality care to plastic surgery patients by encouraging high standards of training, ethics, physician practice and research in plastic surgery. 

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