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Well, the shoulder should fit, and the chest cannot be too small or large. If it breaks at the chest/lapel too much there isn't much you can do. If those areas fit the rest can go in or out. Then the pant waist must be within about two to three inches of fitting (depending who you ask and how bad you want the suit) or it won't work. It shouldn't be too small in the seat or thighs because those areas cannot be let out very much.

It is really best to let a tailor see it in person if that were possible.
 

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Right, the shoulders and neck fit. One more thing, though: do the lapels lie flat with the coat closed but unbuttoned?

Most RTW suit and sport coats are made with a little extra room in the waist. That way, with the above fit correct, you can nip in the waist for a nice fit. Same with sleeve length. Same with trouser waist.

It seems to me it would be rare to find a coat that fit the shoulders and the arms at the shoulders that would be too narrow in the waist. Some ultra-athletic cuts, maybe. Generally, though, letting something out is trickier than taking something in. There's always the question of whether there is enough fabric to allow it.

The second, and perhaps more serious, problem is that letting a seam out exposes the prior thread holes and crease. This is not so great a problem when the garment is new, because the holes have not yet been strained by wear. In a worn garment, say because of a >ahem< weight change, it may be prohibitively apparent.
 

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This may seem like a stupid question, but why not buy a suit that does not require such alteration?
 
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