diff --git a/code/__DEFINES/~skyrat_defines/lewd_defines.dm b/code/__DEFINES/~skyrat_defines/lewd_defines.dm
index f93a82f96f5..90711768d36 100644
--- a/code/__DEFINES/~skyrat_defines/lewd_defines.dm
+++ b/code/__DEFINES/~skyrat_defines/lewd_defines.dm
@@ -29,6 +29,9 @@
 #define BREAST_SIZE_N "N"
 #define BREAST_SIZE_O "O"
 #define BREAST_SIZE_P "P"
+#define BREAST_SIZE_Q "Q"
+#define BREAST_SIZE_R "R"
+#define BREAST_SIZE_S "S"
 #define BREAST_SIZE_BEYOND_MEASUREMENT "beyond measurement"
 
 //ERP Size Areas
diff --git a/modular_skyrat/modules/customization/_globalvars/lists.dm b/modular_skyrat/modules/customization/_globalvars/lists.dm
index 8539e50c97f..5f4ed38dff9 100644
--- a/modular_skyrat/modules/customization/_globalvars/lists.dm
+++ b/modular_skyrat/modules/customization/_globalvars/lists.dm
@@ -19,6 +19,9 @@ GLOBAL_LIST_INIT(breast_size_translation, list(
 	"14" = BREAST_SIZE_N,
 	"15" = BREAST_SIZE_O,
 	"16" = BREAST_SIZE_P,
+	"17" = BREAST_SIZE_Q,
+	"18" = BREAST_SIZE_R,
+	"19" = BREAST_SIZE_S,
 	))
 
 GLOBAL_LIST_INIT(breast_size_to_number, list(
@@ -39,6 +42,9 @@ GLOBAL_LIST_INIT(breast_size_to_number, list(
 	BREAST_SIZE_N = 14,
 	BREAST_SIZE_O = 15,
 	BREAST_SIZE_P = 16,
+	BREAST_SIZE_Q = 17,
+	BREAST_SIZE_R = 18,
+	BREAST_SIZE_S = 19,
 	))
 
 GLOBAL_LIST_INIT(balls_size_translation, list(
diff --git a/modular_skyrat/modules/customization/modules/surgery/organs/genitals.dm b/modular_skyrat/modules/customization/modules/surgery/organs/genitals.dm
index 2220cff5dc2..7fedd284ecf 100644
--- a/modular_skyrat/modules/customization/modules/surgery/organs/genitals.dm
+++ b/modular_skyrat/modules/customization/modules/surgery/organs/genitals.dm
@@ -475,7 +475,7 @@
 /obj/item/organ/genital/breasts/get_sprite_size_string()
 	var/max_size = 5
 	if(genital_type == "pair")
-		max_size = 16
+		max_size = findtext(genital_name, "(Alt)") ? 19 : 16
 	var/current_size = FLOOR(genital_size, 1)
 	if(current_size < 0)
 		current_size = 0