A frequent desire of Indian patients coming for cosmetic breast surgery including lift, reduction or augmentation (increase in size) is a particular size. They often refer to ” I want ’34’ or ’36’ without understanding what they mean. They are however clear in their ultimate goal – a firm, round breast with projection of nipple at the most prominent part of the breast when standing. Very few speak of a smooth slope in upper breast ending at the projected nipple and a little more bulk in lower pole, ideal being upper:lower poles – a 45:55 ratio, as is found in the western countries or desired in models. Even fashionable young ladies know very little about bra and cup size.

For a pretty long time, certain standard practices are being followed with unsatisfactory fit and subsequent physical problems arising out of ill fitting brassiere. To get to the size and cup of bra three measurements need consideration.

A. The circumference in inches at the level of inframammary line (the junction of the breast with lower chest or the breast fold) referred to as underbust

B. The band size – has always got to be an even number is obtained by adding ‘4’ or ‘5’ (some add 5 or 6) to the above A depending upon whether A is and even or odd number. eg. if A is 28” then band size is 32, if 29”, band size is 34. This is the bra size. One must understand that surgeon has little control on it.

C. The bust size – The circumference in inches across the chest at the point of maximum projection of the breast – usually the nipple. When this is same as band size the cup size of the bra is ‘A'(according to some a difference of 1’ is ‘A’ cup) and then the cup size increases for every inch by one. Eg. if the difference between bust minus band size is 1″, it is a ‘B’ cup, if 2″ – a ‘C’ cup. If the result is negative by an inch (very unlikely), it is AA.

Having spoken of the above, it must be admitted that all these measurements give more or less accurate results in young females with ‘A’ to ‘C’ cups. For larger breasts, it is better to measure bust size in supine (lying down with face up) position. Large breasts, particularly hanging ones are difficult to measure properly while standing. It is also to be noted that a 34E may be managed with 36D. Please note this adjustments happens in larger breasts only.

The above measurements had many fallacies and studies in UK & USA proved many women were using wrong sized brassieres more out of the desire for looks than actual measurements, though the manufacturers maintain more or less standard measurements.

It has been found, a more accurate measurement of cup size may be obtained my measuring hemicircumference of breasts – distance between junctions of the chest with breast on the inner and outer sides (across the most prominent part). Multiple studies go on to show that a measurement of 17.5 cms is a ‘A’ cup and for every 2 cm increase, there is one cup increase in size. Even in this method, it is better to take measurements in lying down position particularly in oversized breasts.

So when a patient/client comes for surgery, surgeon should be aware to promise any bra size. A wide chested female demanding reduction in a moderate sized breast may end up with inability to procure a properly fitting brassiere.

Dr. Sasanka Chatterjee
Email: Sschatterjee@gmail.com