Breast Implants Size for 12cm BWD?

Question

Hi, first, thanks to the doctors here who take time to answer questions. I'm considering breast augmentation and still doing my research.I'm currently a 34B (although my band size is probably more like 32), 5"4', 118 pounds, a BWD of 12cm (according to one surgeon), fairly petite but muscular build.I'd like to be a full D cup; but really, as big as I can be without looking "fake." Given this information, how many cc's would you recommend?   Thanks!

Rian A. Maercks, MD · Answer

Be very careful with how your base width is measured.  commonly base width will be measured by examining the existing breast not the goal breast.  The base width used to select an implant should be from just over a cm from midline to the lateral border of the goal breast.  This lateral border is just beyond the chest wall border, and should be a bit farther out if you really want to go that large.  Selecting a base width that is too narrow can create a very strange unnatural appearance and cause the loss of the overlying breast tissue.  I also strongly recommend a subfascial approach if you are planning on going that big as you will have more lasting support.  I hope this helps!

	 

	All the best,

	 

	Rian A. Maercks M.D.

Young R. Cho, MD, PhD · Answer

Thank you for your question and for sharing your photo.  Size of the implants can be very personal choices that a patient makes.  In many cases, patients can go from a A cup to a D cup or larger.  In our practice, I begin by asking whether you are looking for more projection or perkiness and whether you mind have some of the breast tissue push outwards on the side.  In addition, I ask you to try on different external sizers to give you a sense of what your breast may look like and the feel of extra volume in the breasts.  The volume range and the breast shape preferences helps me the further guide you in your implant selection and to give you guidance on what the breast might look.I would visit with some board certified plastic surgeons in your area to discuss your options and goals in more detail.

Larry S. Nichter, MD, MS, FACS · Answer

Natural-Looking Breast Implants ("not fake") vs "As big as I can be" sometimes can be contradictory and you need to discuss this with your plastic surgeon before picking out implant sizes.It is very difficult to determine the exact size and shape of implant that looks natural for you without an examination by a board certified plastic surgeon. This is because several measurements, not just breast width dimensions are needed not to mention your breast characteristics to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be tough to answer your question. Additional critical decisions will also be made by your plastic surgeon such as: whether your implants will be above or below your pectoralis muscle. These choices are recommended to you based on the look you desire, the amount of sagging you may have, and other deciding factors. I always find it helpful for patients to bring in photos from my or other plastic surgeons’ websites to illustrate what they would like to look like. I bring these photos to the operating room for reference during surgery so that I have the advantage of “seeing through my patient’s eyes” to achieve their wishes.I personally order more than one set of implant sizes and use sterile sizers placed in the pocket during surgery to know in advance exactly which implant would work best for you. Software morphing programs can be helpful in some but not all cases (e.g. doesn't work well in my experience with existing implants, sagging or asymmetric breasts).My advice is to accept advice from your board certified plastic surgeon after a formal consultation and examination with measurements.. If still confused don't hesitate to get a second opinion.

Anita Patel, MD, FACS · Answer

If only it were that simple! You provide a lot of useful information in your question, but there is no simple algorithm or formula for choosing implant size. There are many factors to consider, and height, weight, bra size, and base width are just a few. I like to have patients show me what size they want to be, and what they consider attractive and natural looking. Then, on physical examination I take measurements, identify asymmetries, look at the quality of the skin, assess the need for a lift, note the amount of natural breast tissue, and get a sense of overall proportions. Based on the exam and the desired goal of the patient, I decide which profile of implant and what range of volumes would be suitable. In the operating room, I can use temporary sizers to determine which exact size looks the absolute best for that patient. Breast augmentation is not a simple numbers game, and getting a beautiful result involves good decision making as well as good technique. A crucial factor for success is good communication with your surgeon. I recommend consulting with a board certified plastic surgeon in person. Good luck!

Otto Joseph Placik, MD · Answer

I offer patient's a simple analogy to illustrate what we mean:

	Q: If you take a baseball and you cover it with a silksheet, what will it look like?

	A: Like a baseball, you will even see the stitching.

	Q: Now if you take that same baseball and cover it with a comforter what will you see?

	A: It depends on how thick the comforter is but generally you will see a softly shaped lump.

	So now the question is what do you have on your chest, silk sheets or comforters?

	The way we determine this is by looking at your chest, if I can see your ribs (under the muscle) then you anatomy will have a hard time disguising the implant whether it is placed under or over the muscle and you are more likely better off with a silicone implant. Another way of measuring this is to pinch your upper chest skin (similar to pinch and inch of your waist on the Special K commercial). If you have less than an 2 cm (under 4/5 of an inch) than you have "silk sheets"

	If you have a thicker skin/fat/breast layer that pinches over an inch than you have the option of going under or over.

	Now the exception to the rule:

	Q: What happens if you change the baseball to a volleyball?

	A: All bets are off, whether you put it under or over the muscle it will not look natural.

	The last issue is the implant shape. There are some anatomic shaped implants but I have generally found them to produce no significant difference in outcome with the exception of breast cancer reconstruction. However, this is my personal opinion.

Thomas Fiala, MD, FACS, FRCSC · Answer

Hi.  From you question, you have some conflicting goals.  On one hand, you want to look "natural".  On the other hand, you want " full D" on your petite frame.  These goals are hard to reconcile completely.

	While a high profile implant could be used to give you more volume in your petite frame, it will tend to look more obvious / fake.

	So, this becomes a trade-off situation.  Which goal is more important to you?

	In my practice, I find that trying on the sizers in a sports bra, and letting the patient tell me their preferred choice between several different sizes and shapes, works really well.  I think that would help your decision making process.  That way, you could "preview" the approximate look.

	All the best,

Andrew P. Trussler, MD · Answer

I would look at your entire breast dimensions. Just basing size off of a base width is very inaccurate. It depends on your build, how much breast tissue you have and what your skin is like. There are so many factors that go into deciding implant size and shape it is difficult to know exactly what size works for your until you see a board certified plastic surgeon.

Michael Horn, MD · Answer

If you want to look as large as possible for your breast base diameter, use a high profile implant. This implant will give you the most volume possible while using an implant which is not a larger diameter than your base width. Try on the implant model in a bra to estimate your bra size after surgery. But, remember larger breasts sag more with time.

C. Bob Basu, MD, MPH, FACS · Answer

There are several factors that plastic surgeons consider when recommending implant sizes. I consider two factors when selecting implants for my patients:1. Dimensional planning2. Gel Implant Sizing systemDimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look. Hope this helps.Dr. BasuHouston, TX

Sugene Kim, MD, FACS · Answer

There are several variables in determining implant size.  When recommending implant size for my patients, I consider the followings: 1) patients' anatomy (height, weight, chest width, chest height, amount of breast tissue) and 2) patients' desired look/goal.  Without knowing your chest measurement and breast tissue amount, I cannot give you any recommendation.  You should visit with board-certified plastic surgeon who will examine you.  Try implant sizers to get a rough estimate of the size you may want.  As you know, bra/cup size will vary depending on the brand.  Good luck with you.
	Dr. Sugene Kim

Breast Implants Size for 12cm BWD?

Answers (16)

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