I am a 34 waist and I went with large. The fit is perfect and they feel like a good quality pair of boxer-briefs. I removed the pads for washing but perhaps you do not need to. There is a slight difference in the pad's shape up vs down so you can see what look you prefer I guess. I wore them out in the car and while food shopping. You do not notice them while walking or sitting and as far as I could tell they do not seem to bunch up and look natural. The padding squishes down when you sit and would be great for sporting events on bleachers. So. no one commented while I was out but I am giving them 5 stars regardless. They are well made and worth a shot.
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