Yes, there are days when every small breasted girl thinks “hey, maybe it would be cool to have cleavage that filled out a bathing suit”. (Though, to be fair, I imagine large breasted girls periodically think “hey, it would be cool to be able to wear a tube top without a bra.”)

However, before you run to the nearest doctor to get breast implants, remember that you run the risk of looking like you have two cantaloupes strapped to your chest.  Fortunately, we were able to check in with Dr. Sharon Giese to get some perspectiveve on how you can go up in cup size and still look normal. To learn more about her – and what she’s calling the “Park Avenue Ladies Dirty Little Secret” – check out her website here.

We’ve all seen celebrities who have had their breasts done in a way that makes them look really unnatural. Heidi Montag, for instance, has cleavage that looks a bit like a flotation device at this point. Presumably, these are smart people going to good doctors, so why does that end up happening?

There are two reasons. The first is people being pressured to get implants too big for their body. It means that their breasts look rounder and rounder. The next problem is when they put the implants right on top of the muscle. When that’s the case, you don’t have much meat covering the implant. So they look like tennis balls.

What advice to you give clients who want something you think would look unnatural?

I do a few things. When they first come I measure the patient. After I measure them I know exactly how big they can go and still look natural. So now they look through a book of different breast types, if they say I want to be DD, I say “that starts to look fake”. Now, remember, some women don’t care. Lots of people say “I don’t care if it looks fake, I want to be a DD.”

Are there any downsides (other than looking fake) for women who want to go extra large?

There are some risks, and I try to explain those risks. You have a higher risk of scarring. Generally, it can just make the implants hard and deformed looking.

Is there any standard to how many cup sizes someone can go up and still look normal? Say, could an A cup jump to a D cup?

Two. Two generally looks pretty natural. I’d say across the board, everyone can go up a cup and a half and have it look completely normal. It’s a lot tougher to take someone from an A to a DD and have it look natural.

Is it easy to update them if you want to go bigger?

It can be. Let’s say there’s a woman who wants to go from an A to a DD. Instead, we make them a C. Over the years, the skin and muscle around that area will stretch, and then she could go up because it will look more natural.

What if you decide you want to go smaller?

This is actually more common, People get older, they gain weight, they realize they don’t want DDs anymore. I do a procedure that decreases the implant and pushes it more up. They can fall to the sides, so we hike it up. It’s always underneath the muscle in that case.

What do you do if someone has different sized breasts?

That’s very common! Honestly, it’s more uncommon to have breasts exactly the same size. If the difference is small I’ll use the same size implants. If there’s a significant difference I’ll just use different implant sizes.

Do you think there’s an age that’s just too young to consider breast implants? I think for a cosmetic breast augmentation, anyone over 18 is okay. Would I do someone before they were 18? If someone had really deformed breasts. If they were grossly differently shaped, or tubular breasts, that can be psychologically damaging. But I’ve also done them for the first time one a woman who was 65!

Have things changed in recent years? We’ve heard a lot about people in Hollywood worrying about actresses looking “too fake” and I wonder if that’s made a difference in what people look for?

Breast implants in general are still on the rise. I think size is regional. In Texas in Florida people want them bigger than California and the northeast. One big difference is that a couple years ago they allowed silicone implants back on the market. I probably put in 99% silicone gel implants – it’s just a softer, more natural feel.

Are there ever health risks that go along with breast implants? Periodically you hear rumours about them increasing the risk of breast cancer.

No! You do not have increased risk of breast cancer. When you get mammograms they take extra views.

If you want implants, what research should you do beforehand to make sure you’re going to a good doctor?

Women should go to a board certified plastic surgeon with hospital privileges to do breast augmentation. They should find someone who can show them before and after pictures and, this is really important, someone that they feel comfortable with.  I think the biggest reason people have to go back is to change size. Obviously, it’s best to like the size the first time around. And it’s hard to choose. I have the book of images of different types of breasts, and we talk a lot to help the decision, and of course, there’s the exam and my measuring system.  Seeing their personality, too, that helps. Exact same sized implants can look totally different on different bodies.