Choosing the right size IDEAL implant for BWD 14cm - is bigger better? Or will it increase complication risk? (photos)

Thank you for the question.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. 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, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.There are no hard and fast rules when it comes to diameter of breast implant versus diameter of breast (band width). In other words, these measurements are useful but are only one of the many factors come into play when it comes to selection of appropriate breast implant size/profile.





***Given that your surgery is coming up soon, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.



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 "C or D 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/video, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with. 

There are many different factors to consider when sizing an implant.  You want to be full enough to meet your goals in and out of clothing.  Many patients will wish they had gone larger after they get used to a particular size.  But as the implant becomes larger and heavier there can be more "stretch" issues from the weight of the implant.  Think back to any friends that had large breasts when they were younger- they have drooped by now.  Some people say that a "large" implant is anything bigger than 350.  It would not be unusual to use a 400 or 425 in some patients in my practice.  But the point is made that as implants get larger the risk of stretching issues increases.  
The nipple to fold distance on stretch is one of the most important measurements: if it is 7 than an 11 cm base implant, 8, a 12 cm base implant and 9, a 13 cm base implant.  But heavier implants will cause this distance to stretch and increase.  The base width of your breast is most important only in that if you go wider than the base width of your breast it can start to look overly round, like an implant, a look that is undesirable by many if not most of my patients.  But going smaller than the base width is fine.  The implants only reliably  increase the volume of your breast, and if the implant is smaller than the base width it does not tend to appear overly round.  By the way, the ideal implants are measured a little differently in width because they are shaped to sit on a curved surface like your chest wall, not on a table.  You need to add 3 mm to the listed width of an ideal implant to match the measurements of a standard implant.  They need to be undersized a little bit to look natural.
So don't get hung up on the base width of your breasts, it is just one factor and only really important to not exceed.  
I find it helpful to have my patients try in sizers such as the Mentor sizing system in the office to get an idea of how the new breasts will look and feel in clothing.  The range of sizers is selected based on your breast measurements.

I hope this helps!