A surgeon I consulted suggested that my ideal implant size is about 300 cc (HP) maximum to avoid looking too fake. I am an A cup and would like to go up two sizes. Looking at the Mentor HP info, it listed the diameter for a 300 cc HP silicone implant as 11.1 while the 375/400 implants were closer to my BWD (12-12.2 cm). Would 300cc HPs widen the gap between my breasts? Should one only get the implants smaller than her BWD? Me: 5'10/135lbs/28" ribs
Confused About BWD Meaning. I Am 12.5 Cm Should my Implant Diameter Be Less Than That?
Doctor Answers 18
Breast width and implant diameter
The answer to your question is quite straightforward, but the reason for it is more complicated.
A properly sized breast implant should have a diameter of about 3/4 to 1cm less than the measured upright width of the breast with the arms down. This is to account for the skin on either side of the breast width and assures that the implant will fit within the breast and not distort it or under-fill it. If the implant is round this also determines the height of the implant. Because the tissues will accommodate forward fill up to a point, the patient can choose the forward volume (profile) of the implant based on the three forward profiles available in silicone gel implants (both Mentor and Allergan). In other words, the width of the breast determines the two dimensions of the implant but the choice is the forward volume. A high profile silicone gel implant matched to the width of your breast minus about 1cm should make you look two cup sizes larger without looking artificial or distorted.
The reason this works is because there is no good way currently to measure breast overall size before or after surgery or with an external implant or bra. Rather than starting with the volume of the implant and working backwards (the old way of doing it), we are using the best method to fit the implant to the patient's breast, know what effect (roughly) that will have, and then look up the volume. Most plastic surgeons still think in terms of volume rather than three dimensions, fitting without distorting, and what effect that will have based on previous results. I am currently studying the width of the breast preoperatively and at one year after the augmentation to verify that the width of the breast stays about the same.
Confused about breast implant size
Yes it is confusing. I use the breast width measurement as a guide along with other information such as the size you wish to be ,amount of breast tissue present, skin quality, shape of your breast, and your waist and hip proportions just to name a few. I also have the patient try on sizers to get an idea of what she will look like. I spend a lot of time on this prior to the surgery to be sure you get what you expect.
Measurements for choosing breast implants
Your base width is only one measurement used to choose the "right" implant for you. I prefer to use implants that are close to the measured base width--sometimes that means choosing one that is slightly wider or slightly narrower. In general, I try to stick with narrower implants. Wider implants don't fit onto the chest wall as well and tend to have more problems with wrinkling, rippling, and implant palpability.
Cleavage is not normal and you shouldn't expect an implant to give you cleavage. Only a good pushup bra (or a way-too-large implant) can do that.
Your final implant size should be determined by the amount of tissue coverage available (how thick is the breast tissue, muscle, and skin that will cover the implant), what size you'd like to be, and what implant will fit your base width. A good plastic surgeon who is certified by the American Board of PLASTIC Surgery should be able to guide you well. Good luck!
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Choosing breast implant diameter based on your breast base width
Regarding your second question, I try to fit patients with implants as close to their base width as possible, not significantly narrower or wider. Generally speaking, in my experience, the moderate profile plus gives a more natural look than the high profiles. I only use high profiles when patients insist on larger implant volumes than their natural base width will accommodate with a Moderate Profile Plus implant.
How To Pick An Implant
It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below:
Choosing Implants, part 354
These types of questions are the most commonly asked... and are unfortunate in that the implication is that choosing the implant you want is like deciding what you want to eat at the Boston Market counter...
Choosing an implant is really a very nuanced undertaking, and is not as simple as taking a few measurements and looking at a chart.
The very best advice I could give you (and which I give at least 10 times a month) is to spend your time and energy finding a quality, experienced, skilled, and Board Certified Plastic Surgeon first, then carefully communicating your goals for appearance. Then, let your chosen surgeon advise you on the details of the procedure most likely to achieve those goals for you.
This will eventually require you to make a leap of faith, but will greatly lower the risk of you needing a revision surgery when you figure out what we already know- that it is not possible to predict accurately what an implant will look like solely by external measurements and playing with implants in bras...
Base width and implants
An implant will not wident he gap between yoru breasts. That is based upon your anatomy directly. Some implants may narrow the gap betwen yoru breasts a bit.
Choosing the right size implant
When helping a patient choose the right size implant to reach their goals, we take into account several factors, and one of them is the breast width. In general, I recommend an implant that is slightly smaller than the width of the breast-- this will allow it to sit comfortably and have a more natural look. High profile implants give the most projection (distance off of the chest wall, or height of the implant) for a given diameter, but the profile that we choose really depends on a combination of your anatomy, your goals, and the surgeon's experience with the specific implant.
Choosing a surgeon, choosing an implant, getting the best results
Choosing the Right Breast Implant - Whats important?
Although much has been made about the breast width diameter measurement and choosing the "ideal" breast implant, it is not the only measurement that matters. The are numerous considerations that should be accounted for including your size and shape, breast tissue, asymmetry and also your cosmetic goals (how natural or showy do you want to end up, enhance cleavage, roundness of shape). Base width is a guide to help surgeons find an implant in the proper range for a patient - with different profiles adding to the complexity and choices available. Thus, you need to have a detailed conversation with your surgeon prior to surgery based upon what you would ideally like to achieve and trust that whoever you choose understands your desires and the anatomy you possess.
Best of luck, and understand that cosmetic surgery is as much art as it is science.
Vincent Marin, MD, FACS
La Jolla Plastic Surgeon
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.