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

You likely will be very pleased with any of the implants you are considering. The visual difference in your outcome between a 375 and 400 cc device is very small. Literally a few millimeters in each direction or less than two tablespoons! Your BW is a guideline for the maximum width of an implant. However, what is equally important to understand is the BW of your augmented breast. Your tissues will add to the BW of the implant chosen. If you have 2-3 cm of tissue thickness and you place a 14 cm BW implant your new breast will have a BW of 16-17 cm! In addition the added weight of a 14 cm BW IDEAL implant will increase your risks of tissue thinning, rippling and implant malposition over time. Stick to your plans of having a more modest final implant size and weight to reduce your risks over the longer term. 

Hi, for your guidance, here is the breast implant sizing (generalization for most patients):
32A to 32C needs about 250-275cc34A to 34C needs about 300-350cc36A to 36C needs about 350-400cc Please note that rippling usually occurs when there is not enough tissue coverage or when the implants are excessively large, relative to the patient’s breast and breast tissues, or with textured implants placed above the breast muscle. Saline implants are generally at greater risk to develop rippling that silicone. Patients with extremely thin tissues may require adjustment of the pocket size and adding support with Acellular Dermis or other tissue substitutes (biological fabrics) can help with this. Best of luck! #RealSelf100

Selecting the correct size implant depends on many factors in addition to the width of your chest.  As an example, smaller breasted women who have had kids and breast fed are more likely than those who have not, to manage a fuller implant.  The tightness of the skin and muscle tissue are big factors.Although initially after surgery the implants may seem smaller, that will change as the tissue adjusts to the implant- it will stretch.  Over time the implants may even look fuller than you imagined.  I've had implants for 14 year and they look larger now than initially.Women who see me try on sizers to help guide their decision making.  We spend quite a lot of time on sizing because it is such an important issue.  Keep in mind that your choice of  an implant will be with you a long, long time.   What looks good at your age now may not be the one that you want 10 years from now...and they do drop.  Try to select a size that is proportionate to your figure and will never make you look matronly, no matter what your age.The IDEAL Implant has many advantages over the competitors.  It has the best of saline and gel, all in one.  To understand more about IDEAL, click on the link below.  One advantage for you is that the fill volume can be adjusted which is "ideal" for women who are undecided between 2 sizes.  Keep in mind, that overfilling any saline implant will make it more firm, you may want to stay in the midrange to get the best result.In good health,Ellen Mahony, MD

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!

The most crucial factor in sizing implants for any particular patient is the diameter of your breast at its widest point.  If your breast has a diameter of 14cm, the Ideal Implant that will “fit” on your chest would be a 595cc, 635cc or 675cc.  This size implant would appear to be quite large on a 5’5” 135lbs body frame. 
However, the drawing you have posted shows the right breast as actually having a base width diameter of 10.4cm, which would correspond to a 240-270cc Ideal Implant. 

Because the Ideal Implant comes only in a “high profile,” the volume of the implant for any particular width will be greater than that of a “moderate profile” implant. 

In my practice, I have patients pick out the size proportion that they are looking for from my “after” photos, and this allows me to determine what profile will best suit them.  I find this to be much more accurate method of choosing implants than having patients try on various sizes in their bra, since that technique tends to grossly underestimate the size implant needed to satisfy the patient’s needs. 

There is no particular implant size that is associated with an increased incidence of complications, since there are so many different factors to consider from one patient to another.

I hope this answers your questions.  Good luck!

Breast augmentation size, regardless
of whether you're using IDEAL® implants, is a personal decision, so the desired
result is really up to you… within reason. As you've recently discovered
yourself, the "perfect" breast implant size varies for each woman depending
on her natural anatomy, personal goals and about a million other factors. The
key to successful procedures is good communication, so if you’re not happy with
what is planned, get in touch with your plastic surgeon now to iron out any
differences in opinion before booking the date.
 

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.