Confused About BWD Meaning. I Am 12.5 Cm Should my Implant Diameter Be Less Than That?

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

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. 

Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

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.

Sheila Bond, MD
Montclair Plastic Surgeon
4.4 out of 5 stars 40 reviews

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!

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 42 reviews

Choosing breast implant diameter based on your breast base width

Thank you for your question. I would answer yes to your first question. Using 300cc high profile breast implants with a base width of 11.1 might widen the gap between your breasts which have a natural base width of 12.5. A MPP or Moderate Profile Plus breast implant with a base width of 12.5 should give you more fullness on the inside and outside of your breast.

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.

BWD is used to estimate Breast implant size.

There are no hard rules for the BWD  measurement, it is used to estimate the size of the implant . In general I would not go too much larger than the BWD nor too much smaller . You want to fill in the area but not spread so far laterally that the breast are hitting the arm, the skin and breast quality preoperatively also limit the options .

It is best to be evaluated by a Board Certified Plastic Surgeon prior to making a decision.

Walter D. Gracia, MD
Fort Worth Plastic Surgeon
4.7 out of 5 stars 3 reviews

How To Pick An Implant

Best decision is to pick the best surgeon and not try to do his job and pick your own 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:

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Choosing Implants, part 354

Hi there-

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...

Armando Soto, MD, FACS
Orlando Plastic Surgeon
4.8 out of 5 stars 157 reviews

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.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

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.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 149 reviews

Implant diameter & size differs from breast width diameter (BWD) and effects on cleavage

You have forgotten to take into account the thickness of your breast skin and tissue which is generally 1-1.5cm. Therefore an implant with a diameter of 10 cm, when placed in the breast, will actually make the breast measure 10cm + 1-1.5cm (skin towards outer part of breast) + 1-1.5cm (skin towards inner or cleavage side of breast) = a total of 12-13cm BWD. If you work backwards you can see that a 10cm implant will make minimal difference in your breast whereas placing an implant of 12 cm will probably produce a breast that is 14 -15 cm and likely increase the cleavage (make the breasts appear closer together)/

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

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.