Subjective? Two Different Diagram Measurements Btwn Docs
- Asked by HappyMom in WA in Tacoma, WA
- 1 year ago
I got measured for the diameter in sonograms and the first person said my right was 13', left 12. The second person who measured said they were both only 11 and thus I could not size to more than 325cc. This was very disappointing, as i used to be B before kids and figured a ps could help me recover to a full c or small d, which i was during nursing. Does skin not stretch anymore? The diameter differences really threw me.
I have never found that measurement of chest diameter was that useful. With experience most plastic surgeons become pretty good at determining an appropriate implant size. I would go with whichever plastic surgeon you feel more comfortable with. Good luck!
Subjectivity of breast measurements
There are multiple questions and issues here but let's see if they can be addressed separately.
The most subjective measurement of the breast is overall size and volume. The most accurate measurement for this is a surface scanning and software conversion to volume which is not available at a reasonable cost yet and is still potentially thrown off by shape such as ptosis. The amount and weight of breast tissue or fat content of the breast is also not measurable by any simple/consistent means. Fortunately this is not needed for determining what size breast implant will fit behind the breast and look natural. This is best done with a caliper across the center of the breast (usually at nipple level) with the patient upright and arms down. This measurement in my experience varies at least by 1/4 cm at different times or different people measuring. Allowing for skin and some fat layer, the correct implant diameter is about 1 cm less than the measured width of the breast, but this is not exact as tissue around the breast is very accommodating, particularly to the lateral side. The point is to know what implant will fit before the surgery and what effect that will have. In round implants the height is the same as the width and the only choice is the forward projection of the implant -- generally low, medium, or high.
Unless the width of the breast is unusually narrow or wide relative to the chest diameter, a properly width-fitted implant of low profile will increase the apparent breast size by about one cup size although this is far from exact. A high profile will increase it by 2 cup sizes and the medium in between. It is not true that you can just pick a size and get what you want any more than you can just pick a dress size or shoe size. It is best to figure where you're starting from, measure the width of your breast, and figure what a properly fitted implant to your breast will result in.
Skin does stretch but you don't want it to stretch because of a pillow-like implant in a cosmetic result. Stretching causes distortions, unpredictable results, and lack of control of the outcome. Tissue expansion is used in non-cosmetic breast situations to achieve higher volume implants in one procedure but in a single cosmetic procedure, tissue expansion is not generally used.
Are breast diameter measurements subjective?
There is a certain amount of measuring breast diameters that is subjective. It is true that you do not want the diameter of the breast implant to significantly extend past the diameter of the breast, but there is a little flexibility here, and particularly because one surgeon measuring the base width of the breast may be a centimeter or more off the measurement by another surgeon. Unless you have a VERY narrow chest and VERY narrow breasts, I would be surprised if you could not accommodate a larger implant than 325cc in a high profile style of implant (which is narrower and more projecting than a moderate or moderate plus implant.
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Breast measurements are subjective
There is a great deal of subjectivity in breast measurements and breast base diameter and there is rarely a magic number which will indicate that only a 325cc implant or less might be used. We use measurements as a 'last guess' until we can actually see sizers in the operating room. If you were once a D you should be able to be a D again. Focus on the right look for you, and then find a surgeon who will listen and let experience be the guide rather than a number.
Web reference: http://www.peterejohnsonmd.com
Base width and breast implants
Measurements are only a guideline and not an absolute...with different styles of implant, you certainly have other options than what has been presented to you...get another opinion and ask to see before and after photos of patients with narrow chests...some plastic surgeons do not measure at all! Find a surgeon that you are comfortable with.
Base width to size breast implants
Measurements of the breast base can vary depending on the person measuring and when the measurments are taken. For instance some women experience swelling associated with the menstrual cycle which could alter the base width from when they are off cycle. Some surgeons are more conservative by nature and are so with their measuring technique. High profile implants are an option for the patient with narrow base width measurements (11.5 cm and less) who are interested in larger volumes and cup sizes (400 ccs and higher). I would get another opinion. As long as it is reasonable, you should be able to choose the volume you want.
Breast width diameter measurement is variable among plastic surgeons
Some variability in the breast width diameter measurement will be seen when different plastic surgeons perform the measurement since the approximate thickness of the breast tissue is estimated and the beginning and ending marks are also somewhat subjective. Breast width should not vary between left and right since the ideally symmetric breasts have the same breast width diameter when volume is finally equalized. Do not be disappointed or disheartened. Have a few more consultations and get measured a few more times. B cup to D cup is achievable in just about any type of chest and breast type.
All the best,
Dr Remus Repta
Subjective breast width measurements
It is true that these measurements are subjective. In most patients there is not a definitive mark to consistently determine the medial and lateral extent of the breast tissue. Furthermore, the breast width measurement is partly a "guess" because it represents the width of the breast tissue within the breast, not the full width of the breast.
These are guidelines to help your surgeon choose an appropriate size. May I call your attention to full profile implants (Allergan style 45) which at 11.2 cm width will give you a 400 cc implant, which is at least somewhat larger than the 325 cc offered. This implant has more projection than a high profile implant, and is not for everyone.
The reason for this guideline is to avoid the situation where an implant that is too large for a patient's native breast tissue size results in an unattractive appearance where there could be a double contour, one from the implant, and a second from the narrower native breast tissue sitting upon the implant. This risk is more significant the larger the discrepancy. The other issue is over-projection into the axilla, which can be unattractive, and can be a a bother with day to day activities.
Thanks for the question, best wishes.
You would do well to get another opinion, or more, especially since there is a discrepancy in measurements that is affecting your choice of implants!
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.