Natrelle Style 45 HP for 12 BWD and 28 Inch Ribcage?

I had a consult with a PS who suggests Natrelle Style 45 HP 320 or 360 to go from a 32A to a 32 full C or small D. My breast width is 12 and my ribcage is 28 inches. I am 5'2" and 104 lbs. I am concerned that I won't have cleavage or side-boob with this narrow of an implant. If I want this, should I go with a wider diameter implant or is it better to keep the diameter less than your actual BWD? The 360s are 10.8cm wide and 5.1cm projection, so is 10.8 too narrow for my breast width?

Doctor Answers (8)

Breast implant sizing

+2

The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 
Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.


2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.

3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.


4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.


San Diego Plastic Surgeon
5.0 out of 5 stars 751 reviews

Moderate profile is the way to go

+2

The high profile implant does have the narrow footprint and is very projecting within the breast. We feel the implants look rather round and unlike the natural breast. The moderate profile is the way to go. The upper edge will flow better into the breast and not be visible. The implants will not stand up when you lie on your back. And you can worry less about thinning of the breast tissue over time.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 29 reviews

Natrelle 45 Implants

+2

The style 45 implants by Allergan ( branded Natrelle) are very round appearing with alot of projection.  In someone who is 5'2 and 105lbs, I would be worried that they would appear too round, like baseballs.  With a BWD of 12cm, I would recommend going with a 15-339 ( 12.4width) or a Mentor moderate plus 325 ( 12.5cm).  If you want to get a little closer to your BWD, then a style 20-375 (11.7) or a Mentor HP 375 ( 11.8).  Any of those should work with your dimensions.  You want an implant very close or just a little over your BWD so that it does take up the space and give you a nice shape.  If the implant is too narrow, it will make the breasts appear farther apart and with minimal "side boob".  I hope this helps.

Christopher V. Pelletiere, MD
Barrington Plastic Surgeon
4.5 out of 5 stars 23 reviews

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Proper Implant Selection

+1

In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.
Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 37 reviews

Breast implant size choice

+1

In general the breast implant should remain within the diameter of the breast. Choosing a larger implant risks visible folds and wrinkles. Higher profile implants tend to have less rippling but more projection. I prefer the intermediate pofile implants. untess the breast is signficantly narrow or the paitent requestis this look.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Style 45 breast implants

+1

These are the super high profile very "fake" looking implants.  The diameter you can have really depends on examining you in person.  If you go too wide, you run the risk of a uni-boob and that's very hard to ever fix.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
5.0 out of 5 stars 49 reviews

Natrelle Style 45 HP for 12 BWD and 28 Inch Ribcage?

+1

You need further in person discussions with your chosen surgeon. So you fully understand the options. It is called informed consent. I recommend slightly increase to the 400 cc range. From MIAMI Dr. Darryl j. Blinski

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Choosing the right implants

+1

Without a proper exam it is very difficult to offer suggestions for the appropriate implants for you. This is done after careful discussion during consultation.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.