How does the breast width diameter size affect the choice of implant size?

Question

How does the bwd size affect the choice of implant size? PS said I am around 12.8cm so according to the implant sizing chart I should get 375cc mod profile. But thats much bigger than what I want.

Hampton A. Howell, MD · Answer

Hi. To appropriately discuss implant size and choice, you really need an in person evaluation by a plastic surgeon with good experience with breast augmentation.  Obviously, you've met with a surgeon.  Opinions and preferences will vary somewhat from one surgeon to another surgeon.  Personally I start with the base width of the patient as the starting point for the footprint of the future implant.  Even with the base width though, there are different opinions on that and it is not as exact as a lot of people make it out to be.  If you are wanting to be smaller than 375 cc then definitely go smaller.  If you have any hesitation on the process so far then certainly consider getting a second opinion.  Tissue characteristics, and desired postoperative size, and patient anatomy all factor in to the proper selection of implant volume as well as profile.  I go over all of that all in detail with my patients at the time of their consultation.
I would recommend consulting with a board-certified plastic surgeon with good experience in this area.  He or she can thoroughly review the options with you so that you can make a good and well-informed mutual decision.

Finny George, MD · Answer

Hi, thank you for sharing your question. The base of the implant is a circle. The diameter of the circle must fit within your breast. The breast diameter will indicate the maximum diameter of the implant that you can use. You can sometimes go slightly bigger but definitely can go smaller if you wish.

Harry T. Haramis, MD, FACS · Answer

Breast width allows for range of implant sizes. Usually, the implant diameter will be smaller than the breast diameter, but does not have to max out- you can’t put an implant that is wider than the breast width.

You can go smaller than 375, can try high profile also which may fit your body better.

Further discussion with your/a plastic surgeon is recommended until you feel comfortable.

Joshua Cooper, MD, FACS · Answer

-When you choose an implant that is wider than your breast width, you can expect to have more "sideboob" post-operatively. 
-You certainly do not have to go with an implant that is the same width as your current breast width. Many of our patients go with a width smaller than their own, and they are very happy. 
-Breast implant sizing is very important prior to your operation.
-We have all of our breast augmentation patients decide on their implant size weeks prior to their operation. 
- When I first sit down with my breast augmentation patients at their initial consultation, we discuss their goals, the technique of the operation, post op recovery, and potential complications. Then, one of our very experienced staff members does "sizing," using actual silicone implants and a bra. This allows our patients to find which implant size feels best. 
- At a "pre-op" appointment, two weeks prior to the breast augmentation, our patients go through the sizing process again to confirm their choice. 
-We have found over the last 13 years that having our patients pick the implant really helps make certain the correct size is used. Very occasionally a patient picks an implant that just seems way too large or way too small to meet her goals. In these cases, we will help guide them to a better choice. However, this rarely needs to be done. 
- I have seen patients from other practices where their plastic surgeon picked the implant for them, rather than have the patient decide, and in some cases the implant chosen by the plastic surgeon  was too large. 
-Thanks for your question, and best of luck to you!

Ronald J. Edelson, MD · Answer

I don’t use breast width diameter. I always thought it was just a gimmick to make the surgeon look like he or she is scientific about implant size.  375 makes most women a full C. After performing enough breast augmentations the surgeon should know off the top
Of his head what size works.

Daniel Barrett, MD · Answer

Dear nounouk,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ram Kalus, MD, FACS · Answer

For any given diameter the volume (300 versus 400) and projection will vary depending on the “profile” selected (low or moderate or classic, moderate plus or medium, high, ultra high etc.) but implant width is indeed the most important dimension to consider. That said, if discussing Mentor implants, a 12.8 cm diameter Moderate or Classic implant would be 300 cc’s, but in Moderate Plus Xtra a 12.7 cm wide implant would be 405 cc’s. If using Motiva implants, a 12.5. cm diameter implant in “Mini” (lowest profile or projection) would be 310 cc. Saline versus silicone is also important, as is "round" versus "anatomical" or "form stable" or "shaped".

Because all of these options to consider can leave you quite confused, it is crucial that you select an experienced board certified plastic surgeon whose aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion to be sure and feel confident. Make sure that your surgeon sees photographs of your "favorites" or ideal. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

Don W. Griffin, MD · Answer

Breast base width is one of the factors used to determine maximal implant size. There are other factors involved such as amount of native breast tissue and the tightness of your skin. Putting an implant that is significantly wider in base width than the breast width can lead to an unnatural look and create multiple problems. Implant base width does not have to match the breast base width meaning you can choose a smaller implant size and still get a beautiful and natural result.

Nelson Castillo, MD · Answer

Thank you for sharing your question. In order to achieve a proportional result, most implants should approximate your BWD (within 1-2cm), taken in combination with what your goals are with the procedure - breast projection, cleavage, etc. Discuss with your surgeon to ensure your implants are the right ones for your expectations.

Connie Hiers, MD, FACS · Answer

You can go smaller and even choose a lower profile, but I do not advise going larger than what your base will easily accommodate.

How does the breast width diameter size affect the choice of implant size?

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