How far above your BWD can you choose your breast implant?

All women have some degree of asymmetry to the breast. In some cases the asymmetry is so minimal, that it doesn't cause visible asymmetry. In other cases, asymmetry is noticeable and may even be one of the contributing factors for women seeking breast enhancement.
Visible asymmetry can either be corrected by using two different sizes of implants, or by combining breast implants with fat transfer if the goal is to make both breasts larger. In cases where two different sizes of implants are used, your surgeon may either choose to use two different diameter implants or two different profiles of implants. All surgeons have different rules when it comes to maximal implant width for any given base width diameter. Many like to stay within 0.5 cm of the base width diameter, unless you are correcting a narrow breast width (like in cases of tuberous breast).

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, and they choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Dear beauty395,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Totally ignore the bwd method of selecting implants. It’s just a gimmick and usually ends up giving you an implant that is too small. I rely on experience, not gimmicks

Breast width is one of the guidelines surgeons use in helping to select implants to recommend. There are other considerations however. Your board certified plastic surgeon is your personal expert who will consider your anatomy as well as your goals. That information will be combined with your surgeon's experience to help you select the right implant.

BWD is measured slightly differently by all surgeons. BUT, it is a critical element of choosing the right implant to fit your body, juts like shoes need to be the size to fit your foot. If the implant is too much narrower than the BWD, there will be a big gap in the middle (so called "Death Valley") and if it is too wide for you, you could get a "unibreast" or "side boob."