Small implant rec for athletic and bony chest?

I am 5 5 and 118. Currently a small b, deflated breasts after nursing three kids. Final consult is Thursday and surgery 10/31. Any ladies with protruding upper ribs have advice on size? I really want to be a small c only. Thinking 300 or 325 and he said I should do silicone under muscle. Thanks for any tips!

Doctor Answers 14

Sizing in Breast Augmentation

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Thanks for your question.

As others have said, the chest and breast measurements will dictate the appropriate size for your body.  Additionally, the "look" you are going for will also affect your choice and shape options.

From what you have described, the sizing seems reasonable.  If you are thin, I would also recommend under the muscle placement with silicone implants as your surgeon has.  Lastly, don't agonize over the 300-325cc debate - in the end you will not be able to tell the difference, and the extra 25 cc's won't make the outcome look any different - remember that 25 cc's is distrubted throughout your entire breast so that the projection and curvature is virtually unchanged.  However patients tend to obsess over the numbers and if you will feel better that you "went with the bigger size" I think it might be good so you don't have any regrets post op.  Often, patients describe the feeling of great satisfaction, but sometimes wishing they were a teeny amount bigger.  This is a normal cycle of becoming acclimated to your new body and breasts and getting used to your "new norm."

Hope that helps,

Christopher C. Chang, MD

Washington DC, Maryland and Virginia

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

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I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

Silicone will give you a fullness at the top (upper pole fullness).

Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.

These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon



Dr Kayser

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Thank you for your question. Without seeing your photos, it is difficult to give you specific details, however, based on your description, you would likely benefit from a breast implant. For lean athletic patients, however, this can often result in deformities that can make the implant appear ripley and certainly palpable especially in the lower portion of the breast that is not covered by muscle. Placing the implant under the muscle, however, can also result in an animation deformity that can result in distortion each time the muscle of the chest is contracted. This can be quite disconcerting to patients. 

Another option would be to place the implant above the muscle which would eliminate this problem, however, this would increase the likelihood of visible and palpable irregularities. A final option would be to place the implant above the muscle and supplement the breast with fat grafts which would allow the relocation of fat from one part of the body into the areas of the breast that are thin and are not able to be covered by an implant at all. This could improve the contour and fullness of the upper and inner portion of the breast in addition to also adding more cleavage. I would encourage you to view the video below. In any case, I would ask your plastic surgeon regarding these details. I hope this helps and have a wonderful day. Dr. Kayser - Detroit

Implant Size

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Hello and thank you for your questions. I wish you the best in finding the right answers and there are a lot of great answers and information on the forum as well as online on websites. Remember, it is best to see a Board Certified Plastic Surgeon who can in person examine you, take key measurements and go over with you your specific aesthetic goals. Bringing several photos of your "ideal" look can be helpful as well. During the consultation is a review and discussion about the need for a breast lift,  incision location, implant placement, implant size and shape, type of the implants and recovery period. There are several key differences and some similarities in the types and shapes of breast implants. It is best to see and feel in person the different sizes, shapes and textures of the various implants during a consultation with a Board Certified Plastic Surgeon. Best of luck.

Benjamin J. Cousins M.D.
Board Certified Plastic Surgeon

Implant volume

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The only way to size you up for implants, would be to see  you in person.  This is very important so that a proper exam can be performed and a review of your goals can be discussed.

Breast implant selection in the slender patient

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Thanks for your question. In a slender patient such as yourself there is always a challenge finding the right balance. It is harder to hide implants when there is less soft tissue coverage. In The slender patient I recommend:

1) pick a common sense size-- it will be harder to hide a larger implant.

2) Under the muscle- this adds another layer of soft tissue softening the look of the implant.

3) Silicone.-  Provided you comfortable with silicone it gives a more natural appearance. Under the muscle silicone implants tend take on a tear drop shape which is more natural.

4) Don't go too wide.- In general I like to see width of the implant give enough curve under the arm to give a nice balance with the cure of the hip. In a slender patient  erring on a narrow diameter will likely hide rippling and waving more-- even with silicone. If you need more volume think of increasing projection.

When in doubt try on actual implants in your doctors office. I find this a great way to get a sense of the balance you are looking for.


Best wishes

Breast Augmentation - Size Selection

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Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

What size implant

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Without a photograph and direct examination it's difficult to make any recommendations for sizes of implants. Generally speaking, in patients with a bony chest wall, it's been my experience that a shaped implant will have a softer transition from the chest wall to the breast therefore hiding the underlying protrusion. A Vectra 3D imaging platform is used in our office to show the effects of the different types, styles, and shapes of implants on anyone's particular body. Best of luck with your surgery.

Breast Implant Size

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I think that for smaller chested women as well as those with rib protuberance, you should be careful with too large an implant. 300-325cc is not a small implant. Careful discussion with your surgeon and good measurements will ensure a successful outcome.

Good luck,

Small implant rec for athletic and bony chest?

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Thank you for the question.  Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical.  

Having said that, for most patients with a petite frame and anatomic starting point, I recommend the use of round silicone breast implants placed in the sub muscular (dual plane) position. You will find many similar/representative examples on the attached link.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of know words such as “natural” or "small C cup” etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast augmentation surgery  for petite patients) helps. Best wishes for an outcome that you will be very pleased with. 

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.