Implant sizing and chest diameter
For all patients, the implant should have a base diameter that matches your chest wall diameter. For a wide patient this will mean an implant with more volume by necessity. The only reason to go with the moderate plus is if you want more upper inner pole fullness that would be achieved with the more natural looking result from a moderate profile implant.
If the implants are too wide, they will look too large and close to eachother while if the diameter is too narrow, the implants will look like tennis balls with a mile in between.
The use of sizers in your bra preoperatively does not accurately correlate with the size of breasts achieved with sub muscular implants. I think that it is very important that you communicate clearly with your surgeon to maximize the chances of achieving your desired breast size.
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” 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. 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.
I hope this helps.
I always prefer to use the moderate profile plus saline implants. The reason is that they are adjustable on the table to a large degree. The moderate profile plus implants and usually be "over filled" by approximately 80cc. I you go with an implant in the 450cc range than it can be fill to over 500cc with added projection. Your surgeon can adjust them on the table.
Discuss your options with your surgeon
This is a dimensional assessment that you need to do with your surgeon at pre-op to figure your best implant dimensions As each surgeon has his or her own way of doing things, you will only get confused reading options on this topic here.
Enjoy your new look.
Take care in selecting implant profile and volume
It is important to pick an implant with the appropriate base diameter that matches your own anatomy. Think of an implant as the base of the breast pyramid. An implant does not look like a breast, it forms the base of the new breast pyramid. An implant will simply give you a bigger version of your existing breast and will not make you look like anyone else. The best information about which implant to use will, of course, come from your plastic surgeon. It is good to bring in pictures of your 'ideal breast shape'. From all of this information your surgeon will be able to select the right implant to give you a result that is closest to your expectations.
If you have already selected your surgeon, you should direct your questions to him/her. Having too many extraneous opinions from doctors who haven't examined you may muddy the waters. Each doctors has a method for selecting the implant for a particular patient. There are always trade-offs that force you (or the surgeon) to make difficult decisions because there is rarely a "perfect" choice. One question I ask a patient is: If you came out too big or too small, which would make you more unhappy?
Your surgeon can use implant SIZERS during surgery to determine best implant.
As a generalization, it is a mistake to go too big with breast implants. Very large implants age badly. 450 cc's is more than enough. The base diameter of the implant should be at least one centimeter less than the base diameter of your breast.
In Manhattan, we use breast implant sizers during surgery to see which particular implant looks best on you. We do this before opening the permanent implants. A sizer costs only $45, and it takes all the guess work out.
You can take a look at the video on my web site.