What happen if I picked moderate plus silicone implant that bigger than my base width? Uniboob and less fuller look? (photos)

Question

I am a 5ft2 lady with 112lbs, 34B. I have a base chest width of 13.5. I desire the full looking breasts but prefer it to be placed under the muscle. I would like to go for Mentor 500cc with 13.2 width and 5.4 projection. But the doctor keeps trying to make me go down to moderate plus 420cc, 13.1BWD and 4.6projection. Now im settling for moderate profile 460cc, 13.6 BWD and 4.7projection. He said the breasts will sticking out to side. Will I get fuller looking breast like my desired pictures?

Aldo Guerra, MD · Answer

I appreciate your question.
I always leave the ultimate decision about implant size and shape to my patients. I only suggest different options, but do make strong recommendations. I don't try to talk patients into any kind of size and shape, but allow them to have the freedom to choose their best liked implant from all the choices (after all, it is a free country). 
However, I think it is good to listen to your plastic surgeon and consider the rationale behind one versus another choice. I like all the implants you have mentioned, but I believe you will be happiest with your original choice. Communication with your plastic surgeon is the key to getting the result you desire.
If you feel your communication has hit a hurdle, then I suggest speaking with another plastic surgeon to get a different perspective. 
Good luck, Dr. ALDO :)

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.
  
The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  
  
Silicone will give you a fullness at the top (upper pole fullness).
  
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.
  
Anatomic gummy bear implants might be a good choice to give you volume.
  
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
  
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.
  
The best way to assess and give true advice would be an in-person exam.
  
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
  
Best of luck!
  
Dr. Schwartz
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Curtis Wong, MD · Answer

if you have narrow breasts and a huge space between your mounds.  If your space between the mounds is 2 cm or less, I would not exceed your base width.  It sounds like your surgeon wants you to go smaller.  In my practice, my patients employ external sizers and have uniformly been happy with their outcomes... I always add 10% to the sizer chosen.  So if your surgeon is reluctant to accommodate your desires (and you're fully informed), then find a surgeon that will make you happier, at least for the moment.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.  
 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.

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.  There is definitely some leeway when it comes to measurements and breast implant options (breast surgery is an art as well as a science).

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.

***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 “full looking breasts” or "D or DD 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.

What happen if I picked moderate plus silicone implant that bigger than my base width? Uniboob and less fuller look? (photos)

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