Breast Implants for Petite Woman. (Photo)

Having your implants look natural and proportionate to your frame are excellent goals to shoot for.  Your board certified plastic surgeon can help you choose the size that is right for you with different methods of sizing available.  It has to be done in person though since a good physical examination of your tissue qualities with measurements of your breasts is imperative.  There are currently 3 FDA approved breast brands in the US and they are very similar in quality, durability, styles available and durability.  The biggest difference between the 3 brands is the type of "gummy bear" silicone implant they offer.  This is the newer highly cohesive, form stable, anatomically shaped silicone gel implants.  I believe this is the best type of implant currently available due to its natural look and feel (with less rippling and more natural and predictable shape) and less rate of rupture, capsular contracture, gel migration and tendency to maintain its shape better over time compared to the saline- filled implants and the classic silicone gel implants.  These implants are tear drop/ anatomically shaped.  The other styles of implants most commonly used are round and smooth.  All these different types of implants come in different profiles (low, mid- range and high profile usually).  The lower profile implants will give you a more natural look while the higher profile implants can give you more cleavage, upper pole fullness, roundness and lift. The higher profile styles are also more commonly used in petite narrow chested patients who want more significant volume increase as the larger the implant chosen, the larger the diameter of the implant which could end up in your armpit and give you too much side boob if your implants are too wide.  An experienced and skilled board certified plastic surgeon can help you choose the size and style to help you achieve your goals.  The most commonly used incision location for placement of silicone gel breast implants is the inframammary fold.  It has the least risk for capsular contracture, which is one of the most common indications for revision surgery in the future and can be used for future revision surgeries, saving you the need for a second scar.  The most common tissue plane implant placement is the subpectoral approach which looks the most natural, has the lowest rate of capsular contracture and rippling, stays out of the way of mammograms more and maintains it's shape better over time than subglandular or subfascial (which is basically subglandular and still has a high rate of capsular contracture).Judging from the pics you submitted, you should have a very nice and natural result.  You do have more of a gap between your breasts than the average patient and that can only be improved a little.  It's just a limitation of breast implants and everyone's anatomy is different so we cannot make everyone look like the model in the picture.  Then, there is also the lipoaugmentation option, but that should be saved for another topic of discussion.... Best wishes.

Good morning!Looking at your photos you appear to be a great candidate for augmentation surgery- I am sure you will do well.  As far as size/shape/profile questions- these are things that only a consult with a board certified plastic surgeon can answer- he/she are the only ones with the experience to be able to match the implant you need with your body type.I hope this helps

It is very possible to achieve a natural result with a petite frame.  The implants you choose will directly influence the outcome that you get.  Your plastic surgeon can show you different implants that fit within the dimensions of your breasts, and give you an idea of how they will look after surgery.  Keloids can be treated with different modalities, and certainly can be addressed at the time of your breast surgery.  Best of luck!

Thanks for your question and pictures.  It appears that you would be an excellent candidate for a breast augmentation and should get a very nice result.  Shape, size, and profile of implants will all be determined at the time of consultation based on chest measurements done by a board certified plastic surgeon.  Silicone implants are great devices and are an excellent choice for your augmentation.  Inframammary incisions (fold under breasts) typically heal well but even if they do thicken, they will be well hidden.  Keloid scars can be treated with steroid injections.  The central portion of the chest is a common area for people to form keloids, even if they don't form poor scars elsewhere.  Good luck!

For natural appearing breasts, I prefer to use silicone implants of a moderate plus profile placed in the dual plane (submuscular) position. Higher profiles tend to give you a more rounded, shelf appearance. It's hard to determine your best size without specific breast measurements and an in person exam. Remember to choose a board certified plastic surgeon who actually takes the time to measure you and examine your breast pocket. The goal of breast augmentation is to optimally fill your breast pocket, not to overstuff or understuff it. At my practice, we utilize a series of 5 breast measurements that help me determine the implant size, which in turn helps me deliver a 24 hour recovery. Do your research and choose a surgeon who takes the time to sit down with you and discuss your goals/expectations to determine the best size for you. Remember that sizers will only give you a rough estimate. Also, keloids can be excised but often return so best to use steroid injections to flatten them. I use an incision in the breast fold so it isn't very noticeable even if it does become a bit thicker. Good luck!

I appreciate your question.

The size of implant best of 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.At the time of your consultation, your plastic surgeon can talk to you about keloid removal/revision.

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

Hello,Thank you for your question. The best way to determine the sizes/volumes of implant which will meet your needs is to have a detailed discussion with your Plastic Surgeon and careful measurements taken which will determine your implant diameter. You will likely have a range of implants with the same width but increasing projection/volume as options for you. My patients find it helpful to try the implants on in the office with a form fitting T-Shirt in order to get an idea of the look that they like. Ultimately, I suggest that you choose the best implant for you based on the look you want, rather than a desired cup size because there is no standardization for bra cup sizing.I'm sure that your Plastic Surgeon will be able to talk with you about removal of keloids.All the best

If I was to do your operation I will use 300 cc smooth silicone moderate profile implant in subgladular location through inframammary incision. Keloid is unavoidable risk in patients who form keloids.    

Thank you for your question and photos.  I believe you would be a great candidate for breast augmentation.  If there is concern about keloids,  I would place the incision at the breast crease.  Also, any keloid excision should be complemented with a steroid injection (kenalog) to reduce the risk of recurrence.  If you prefer silicone implants, round smooth silicone implants in a sub-muscular pocket would be a great approach to achieve a natural look for your frame.  Keep in mind that the FDA recommends getting MRI exams every couple of years if you have silicone implants b/c there's a small chance that they can rupture without it being clinically detectable (silent rupture).  Another option is the new FDA approved new generation saline implants, called IDEAL implants.  These feel more natural than the old saline implants but have the reassurance of not having to worry about silent ruptures or follow up MRIs.  During the consultation, you should be measured for your breast dimensions in order to get an appropriate range of implant sizes.  In my practice, I have my patients also try on different implant sizers in a simple bra while wearing a tight t-shirt in order to get a better idea about the look they want.  Don't focus too much on the cup size or implant volume but more on the look you want.  Be sure to consult with an experienced plastic surgeon certified by the American Board of Plastic Surgery.  Good luck!

Dear Ms. Selena_03,Thank you for your story, question and photos. Nothing substitutes for a personal evaluation and a face to face discussion of your options.Unfortunately without photos, a examination and measurements I can advise you in general terms, however I hope you will find them helpful.Breast appearance, size, filler material , shape and implant location is a personal choice guided by the experience of your Plastic Surgeon. Your SPECFIC breast anatomy will dictate some of your choices.As far as size you know all bras are not equal in "cup size" measurements."Cup size" is a very crude and non standardized measurement and varies by bra manufacturers. Thus actual cup size you eventually are measured at is not as important as your body proportions as it relates to your desired breast size My specific responses are:1)sizing:A)Realizing there are no standard bra (strap/cup) sizes, purchase several bras (full bodied and no padding) of the strap and cup size you think you want to be. B)take a measuring cup (1 oz=30cc) place rice in a nylon. Therefore 10 oz. = 300cc...C) try on various volumes of rice with some form fitting clothes.D)if implant is placed under the pectoralis muscle I usually add 10% volume to what the patient chooses.... To compensate for the muscle pressing down on the muscle and for the naturally settleing of the implant which often makes the breast appear smaller 2-3 months after surgery.2) profile of implant:A) for the same volume the higher the profile the narrower the base width.B)there is very little difference in projection between a moderate to high profile implantthus little affect on how the actual nipple will look.C) the base width of the breast should equal the base width of the implant D)thus I personally chose the profile based on the patients chest measurements, (a high profile on a wide chest may not result in the cleavage desired and conversely a low profile on a narrow chest may result in implant in the outside armarea)E)Cleavage is largely determined by your anatomy. This can be optimized by choosing the best profile implant and postoperative implant displacement excercises towards the midline of your chest.3)Shape of the implant:A) for the vast majority of cosmetic patients I recommend round implantsB) reconstructive patients shaped/form stable implants are often used4)Placement decision of implant(subpectoral, dual plane, or suprapectoral) will be determined based on your anatomy and long term goals and benefits.5)Filler MaterialA) silicone gel feels more like breast tissue, less potential rippling, comes prefilled cannot adjust size intraoperatively and larger incisions to place compared to equal sized (non prefilled) normal saline implants.B) normal saline implants can be adjusted in size intraoperatively, if ruptures normal saline absorbs, potential increase rippling compared to silicone gel, smaller incision to place normal saline implants as compared to prefilled silicone gel implants.6)Incision (access) sitesA) axillary B) areolaeC) inframammarry foldD) umbilical (normal saline implants only)keloid formation ion can be minimized by several postoperative options:1) silicone gel tape2) lasers3) steroid injectionsI suggest you collect several nude model photos of the goal breast shape you desire and schedule several consultative appointments with Plastic Surgeons who are experienced and is Certified by the American Board of Plastic Surgery and ideally members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).My best wishes,R. A. Hardesty, MD, FACSDiplomate and Certified by the Am. Bd. of Plastic Surgerywwwimagineplasticsurgery.com4646 Brockton AveRiverside, Ca 92506(951) 686-7600