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
4.5 out of 5 stars 38 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 38 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.


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 23 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 141 reviews

Choosing a surgeon, choosing an implant, getting the best results

The best way to determine the size that fits your personal perception of the perfect breast is to try on sizers. This way you can see how they fit on you, how they add to your current volume, and whether they fit your frame. Although the surgeon can guide you, only you will be able to tell what is the right size. Try on sizers. HP implants, which are a more modern shape than moderate profile implants, fit most women better. They have a more appropriate base diameter for the average women's chest. Mentor HP profile saline implants have base diameters that range from 8.8 cm (very narrow) to 13.8 cm (moderately wide). The majority of women in my practice have base diameters in the 11 to 13 cm range. The HP implants fit them well. The moderate implants have much wider base diameters for the same volume (often in the 14 to 15.6 cm range). These implants are too wide for most women that I treat. So when the base diameter is measured and correlated with the diameter of the implant, it is most often necessary to use HP implants to achieve the volume the patient is requesting. At the volume selected, my patient's base diameters are too small for moderate profile implants. Measuring a diameter and then telling the patient what volume they can have (in high, moderate or moderate plus implants) in my mind is backwards. The patients should be allowed to choose the volume. Then the surgeon carefully considers the base diameter, projection, profile, manufacturer, and fill material that will achieve the patients goals of size as well as qualitative look (natural, intermediate, or bold upper pole fullness or projection), all the while taking into consideration the patient's anatomic features that will affect the outcome. HP implants can be made to look very natural or very augmented, depending on where in the range the implants are filled to achieve a particular volume. At the low end of the fill range, HP implants do not have the upper pole fullness that most people associate with the fake look. On the other hand, a fake over-augmented look can be created with a moderate profile implant if it is overfilled (a common practice for surgeons that commonly use moderate profile implants). In addition, too wide an implant will put the volume past the anterior axillary fold, which in my opinion, looks more fake than upper pole fullness. So there are many factors that need to be considered. The experience of the surgeon and the degree to which they explain the options to you is of utmost importance. Obviously all of my patients look at photographs and we evaluate the look they are desiring in great detail. For me, high profile implants are the first choice. I rarely find an indication to use moderate or moderate plus implants. Look at the outcomes and judge for yourself. The outcomes should stand on their own. The subtlety in the final outcome is not achieved by which profile implant is used, it is determined by the skill in the creation of the pocket, the choice of volume, and where in the range the implant is filled. Don't let the doctor tell you what would look good on you. They cannot tell what you perceive to be the best size.

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:
#HowToPickAnImplant

Understanding Base Width. It's not the Only Measurement.

You are correct, that if you put in implants with too narrow a base width, then you can end up with a 'space' between your breast mounds.   Not good. 

Base width can be adjusted to a desired base width, slightly, but for a natural result, you need an implant that is similar to your natural base width. 

Once  the base width is chosen, then different profile implants can be chosen to achieve the desired size.  300 cc implants won't increase you two cup sizes, possibly closer to one cup size. 

With shaped implants, we have the ability to control the width, height, projection and volume, and better customize the implant choice for a better fitting and more natural result.  

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...

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.