There are two differing philosophies about breast augmentation. Some surgeons encourage patients to go a little larger than they initially want because so many people come back later wishing they were "just a little bit bigger." My philosophy for augmentations is to make the patient look natural. In my experience, some patients who have very large implants eventually wish they were actually smaller. With time the breast tissues thin out; and it leaves fewer options for revision. Sometimes people begin to droop a lot and it is hard to lift their breasts when the tissues are too thin. If breasts are already very ptotic (drooping) then I will often recommend a breast lift in addition to augmentation. Finally, it is very important to know that no two breasts are mirror images of each other. Though we can make improvements, there is no way to make both breasts perfectly symmetrical. For this reason it is important to have realistic expectations as to what simple implants can do for you.