Do I have too wide of a chest divergence and am I too flat for breast augmentation? (Photo)

Question

I've always been very self conscious of my flat chest and nipples. I plan to get my nipples corrected one day (post kids) but want my boobs done ASAP. Are my breasts set too wide to have implants that would look good? Any recommendations? I'm a small 32 A and would love to be a full B. I'm very athletic so don't want anything large, just want to feel feminine and fill out a bra. Picture 3 and 4 show a "boob goal" picture. Not sure if I can ever achieve that.

Gianfranco Frojo, MD · Answer

The process of selecting an implant is one of the most important aspects of breast augmentation. I would go see a board-certified plastic surgeon (ideally with 5 years of plastic surgery residency training and a 1 year aesthetic fellowship). I would go see a surgeon who has the ability to perform 3D preoperative imaging to show the potential results utilizing tissue-based measurements.

Bora Ok, MD · Answer

Hi from Istanbul! For patients looking to have closer-set breasts, I recommend placing implants over the muscle but under the fascia. With the right choice of implants, this approach should work well, allowing you to achieve your desired look. Hope this helps!

J. Timothy Katzen, MD, FACS · Answer

Hello CO Runner 2016 in Denver,
Thank you for reaching out with your concerns about breast augmentation. Based on your history and photos, you're certainly a candidate for this procedure, despite your concerns about having a wide chest divergence and being too flat.
Breast augmentation can be tailored to your specific anatomy and goals. Whether saline or silicone, each type of implant has its advantages. Saline implants offer adjustability in size, while silicone implants are known for their natural feel and appearance, and they tend to have a lower rate of capsular contracture.
There are various surgical approaches for implant placement, including incisions around the nipple, beneath the breast, through the armpit, or even via the belly button. Given your desire for a B cup size, an implant size ranging between 250 and 300 cc could be suitable. The choice of incision under the breast or around the nipple can work well for this size.
Your active lifestyle is an important consideration. Placing the implant above the muscle or in a dual-plane position (partially under the muscle) might be optimal to align with your physical activities. A dual-plane placement can provide the benefits of both submuscular and subglandular placements.
Recovery time varies, but typically, a week off is recommended for initial recovery. It's essential to have a detailed discussion with your plastic surgeon to explore your options and to plan the procedure that best fits your body and your goals. Breast augmentation can indeed be a life-changing procedure, enhancing your self-confidence and body image.
I hope this provides clarity and reassurance regarding your potential for breast augmentation. Feel free to discuss all these aspects thoroughly with your surgeon to ensure the best outcome.
Sincerely,

Brian K. Reedy, MD · Answer

Thanks for your question!
You appear to be a good candidate for breast augmentation surgery. Schedule a consultation with a board certified plastic surgeon to discuss your options. Best wishes!

Daniel Barrett, MD · Answer

Dear COrunner2016,
based on your photos, it looks like you would be a good candidate for surgery. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size implants. 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 is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. As you undoubtedly know, a precise treatment plan or specific implant recommendation can only be determined with a careful examination and detailed discussion with your plastic surgeon. Volume (200 versus 300), is far less significant than implant width and projection. Implant width is similar to shoe size. The implant literally needs to fit into your breast and chest. It is true that for a given volume a high profile implant will have a narrower diameter, and it is also true that a person such as you with a petite frame will require a narrower diameter implant than a patient with a broader chest or larger frame.  Other considerations such as saline versus silicone are also important, as are "round" versus "anatomical" or "form stable" or "shaped", smooth surface versus textured, and softer versus firmer with the different levels of gel cohesivity.

The term “natural” can mean different things to different people and the profile of the implant does not necessarily determine that. You can certainly achieve a “natural” appearing result with a high profile implant if properly selected, but as a rule, the larger the implant and the higher the profile, and certainly if the implant is positioned too high, the greater the chances you will look “augmented” because of exaggerated upper pole fullness or convexity.

In my practice, besides a thorough interview process and physical examination with careful measurements, we use on lay sizers within an unpadded bra to help you understand what you are likely to look like in a bra, bathing suit, or T-shirt with a given size implant. In addition, and this is critical, we ask all of our patients to provide us with photos of their desired final look, with images of women’s breasts that most closely resemble the look they are trying to achieve. This serves as a visual guide that thankfully rarely leads us astray. The most common reason for patient disappointment after breast augmentation is size-too big or not big enough. This algorithm which we have been employing for over thirty years has proven to be very successful.

Because all of these factors 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 if necessary to be sure and feel confident about moving forward with scheduling surgery. 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.

W. John Bull, MD · Answer

After reviewing your photos, you would be a good candidate for breast augmentation. Selecting the proper implant to achieve your goals as well as how the implants are placed will be the key to achieving your goal. It looks like you have already seen a plastic surgeon from the first 2 images- they look to be from a vectra machine, which is an excellent way to get an idea of what your breasts would look like, but that is still user dependent. Meaning, the image and placement of the implants would need to be adjusted to achieve the desired result in the pictures. Also I would agree with waiting on correcting your nipples as this may improve with both implants and pregnancy.

Gary M. Horndeski, MD · Answer

Your breasts are widely separated. I recommend a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

You are. Good candidate for breast implants. However because as you point out your breasts are wide set, expect there to be a gap between the implants. But it’ll still look great

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