Why do doctors measure breast width diameter different ways?

Question

Hello! Ive been to many consultations with 5 diff doctors and 3 of them measured my bwd differently than the other 2. 2 doctors measured my bwd how most doctors do and my bwd came out to be 11.4 but the other 3 drs measured my bwd from more up my breast because they said im "wider at top" so when they measured it more above, my bwd came out to be 12.5 so i was able to put more cc's in. If this is the case, why dont most doctors measure this way if patients with wider breast above want more cc's?

Eugene Kim, MD · Answer

Thanks for your inquiry.  Every doctor has different ways to assess
their patients and choose the right implant sizes.  It is not uncommon to have 3 different measurements
from 3 different plastic surgeons.  Some
doctors are very diligent about sticking to the numbers of the base width
diameter and others a little bit more liberal with it.  So, I would not focus on the actual numbers,
I would focus more on the results you are looking for and whether or not your
doctor can achieve those results.  One
way to do this is to look at the doctor’s before and after photos and find
photos that are similar to your build. 
Then, look for results that look similar to what you want.  I hope this helps.

Austin Hayes, MD · Answer

Every surgeon has their own technique. What is most important is that it's consistent and reliable for them. The width of the breast determines the diameter of the implant that will be used. Good luck with your upcoming surgery.

Donovan Rosas, MD · Answer

There are a number of measurements which are important in the planning of a breast augmentation including: breast width, nipple to IMF distance, nipple to sternal notch distance, tissue pinch. Each is important but their true value is in the sum of the whole. One measurement does not a decision make.Traditionally, breast width is made at the level of the nipple (typically the fullest point on the mound. However, depending upon who is taking the measurements there may still be some variations noted. Studies have actually demonstrated this variability and the subjective nature of the measurement due to interrater reliability.The best decisions are always made with as many data points as possible. As always, discuss your concerns with a board certified plastic surgeon.

Payman Danielpour, MD, FACS · Answer

Great question.  There's always some variability due to human error and technique therefore in my practice I always use the Vectra 3-D imaging system for my measurements and a live simulation of what different in plants look like on your body.  I highly recommend that you use this type of technology to plan for your breast augmentation surgery.

Farbod Esmailian, MD · Answer

The "proper" way of measuring base diameter is to measure at the level of the nipple/areola.Having said that, every one is different and in certain cases the surgeon will have to do things different whether it is the measurement or the intraoperative assessment, to get the patient the optimal result.At this point I would focus on the plastic surgeon that you felt most comfortable with and that you feel would be the one to get you your optimal result.Good luck.

Curtis Wong, MD · Answer

and that includes how the width is measured.  If your 11.4 surgeons are limiting your volume due to you width, go with the other surgeons who are willing to use larger implants.  All surgeons should want the best outcome possible so choose who will do the best for you.

Adam David Lowenstein, MD, FACS · Answer

Many different surgeons have different techniques for surgery, as well as different techniques for measuring breasts and the pre- and post-operative care of their breast augmentation patients.  Similar to the phrase "there are many ways to skin a cat" (which, by the way, is a horrible saying if you think about it), there are many ways to end up with a great result from breast augmentation surgery.  If your surgeon is experienced and has a great reputation, has good results and you have a great rapport with her or him, then you should be confident that they know what they are doing in their particular method.Best wishes, Dr. L

Tom J. Pousti, MD · Answer

Thank you for the question.  As you have found, there is no "standard" technique when it comes to dimensional planning.  Also, there are no hard and fast rules when it comes to diamension 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.

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.

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.

Frederic H. Corbin, MD (license restricted) · Answer

Good question and each surgeon has his technique that hopefully gets him to the desired result with patients.  There are variations on all measurements even when taken by the same surgeon and a 1.1cm difference is not very great.  It would more determine the width of the implant used not the cc'sDr. Corbin

Jon A. Perlman, MD (retired) · Answer

Your very good question points out the lack of precision in determining breast implant size and volume based solely on subjective measurements.  Although measurements are somewhat helpful especially in avoiding the extremes of implant selection in my opinion, many of us feel that a better aesthetic result can be obtained by the use of test implants during surgery when the implant pocket has been created and the actual results of the particular implant can be seen.  Having multiple implant sizes available for the final selection enhances flexibility and aesthetics in my experience.  When measurements have been used to select an implant size prior to the surgery there is no room for variation during the surgical procedure if the result is slightly smaller or larger than the goal.My advice to you would be to allow any of the surgeons with whom you have consulted to perform your surgery and show them goal photographs asking them to match your goals as closely as possible making the decision during the surgical procedure as to which implant you receive.  I am certain each one will do his/her best job using their aesthetic sense on your behalf.  I also recommend that you watch the video link above for information how I choose implants for my patients to best match their goals.  Best wishes,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, California

Why do doctors measure breast width diameter different ways?

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