Choosing the right size implant

I feel that the patient needs to be educated to make the best decision possible when choosing implant size. I encourage my patients to bring in a picture, or pick out a picture from our photo album, of what they are looking for. I will measure their breast width to determine what profile best suits their frame, and will go over the differences in the profiles of the implants as far as diameter and projection to educate her.  We will then "try on" a series of implant samples in a bra to determine what size she is most happy with. This gives me a starting point to know what volume, projection and diameter she is looking for and what will suit her frame. Ultimately, the choice is hers. 

There are a number of ways that one may pick the right size implants for themselves.

• One way would be to bring in pictures of other women's sizes that they think would look good on them.

This is somewhat subjective, and leaves a lot unanswered, as it depends on the plastic surgeon's experience level to be able to match up the size and shape of someone in a photo to the patient bringing it in. There can be differences in height, weight, and shape of the chest wall from a photo to a patient, but this can be valuable.

• Another option is to try on sizers in the office. This means putting an implant in the bra to get the preferred look.

There is usually a conversion volume that needs to be added or subtracted to come up with the correct size. In my office that volume is 50 grams more than what is placed in the bra. The reason for this is that the pectoralis muscle flattens out the implant when it is in the patient.

So to get the look of the sizer, I have to add 50 grams to the sizer to convert to the actual implant. This is the favored way for my patients to choose the appropriate size.

• A new way to choose implant size is to use a 3-D camera with computer simulations that may help in selecting the size and shape.

There are currently at least two 3-D systems available. They are Axis 3 and Canfield Medical. These take your own photo and convert it to the virtual size that you tell the computer to simulate.

I find that patients really like to participate in selection of their size, so the more interactive it can be for the patient, the more they like it. We actively try to encourage our patient's input.

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I like to stay within the width of the patients base diameter for the breast.  Having said that, you also want to stay in proportion to the rest of your body, in particular to your gluteal region.

What you can do is th rice test (which I describe on my website) or try out sizers at the doctors office.

Good luck.

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I think it is important to find out what your goals are. I hope you are looking for an implant which is proportional to your body, and looks and behaves as naturally as a breast implant can look.

To achieve this goal, the surgeon must choose an implant which can comfortably fit within your chest width and height. The amount of breast and soft tissue will also determine the volume and style of implant (low profile versus high profile).

The implant pocket, in my opinion, should be slightly larger than the implant itself, so that the implant can move and settle naturally.

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Hello,

Breast implants can be placed to look good over time at moderate sizes. Larger implants give a more "fake" look at the risk of needing much more surgery over time.

You really need to decide upon the look you want and consider the risk profile of going there. Then when you have considered all of this, you are prepared to make a choice.

Best Regards,

JPD

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