Can an implant be larger diameter than BWD?

Question

I have a BWD OF 11.8 & I am scheduled for 415cc Sientra HP smooth silicone. I looked up the measurements and see that it’s 12.5. I am concerned that this implant may be too large for me. Will it likely be? From what I’ve read I’m supposed to be at or under my BWD. Thank You!

Franziska Huettner, MD, PhD, FACS · Answer

Dear Magical7697,
Thanks for your question — and for doing your research! It is true that in most cases the implant should be the same width or smaller than the BWD measurement. While it is possible to place a larger implant and this may be perfectly safe in some cases, in general, this could lead to a less ideal result. I would recommend speaking to your surgeon about this — with the breadth of implant shapes and sizes available, it seems unnecessary to choose an implant that may not be the best fit for your body. Also be sure you are working with a board-certified plastic surgeon who has demonstrated experience performing breast augmentations. Best of luck!

Jeff Angobaldo, MD · Answer

Hi there! Thank you for the question. The answer is, yes it is possible, but no its not recommended. Just because it is not recommended does not mean it isn't safe. Without pictures it is difficult to tell what the surgeon may have been thinking. If you have skin laxity or a wider gap sometimes surgeons will opt for a slightly larger implant to cover all basis and fill in the areas of concern. However, a larger implant can mean more stretching of the skin, which may or may not result in sagging over time or what they call bottoming out. I would contact your surgeon, discuss your concerns and see if he can help alleviate some anxiety you may have. Hope this helps.

Michele A. Shermak, MD · Answer

Hello!You are correct. The width of the implant should be no more than the width of your chest, and actually should be the width of your chest minus the tissue width. I would recommend you circle back to your surgeon. It may be that you can go up in profile to reach the larger volume rather than have a wider less projected implant. Be sure you are seeing a board certified plastic surgeon. Best of luck!

William Andrade, MD · Answer

Hello, technically an implant larger than BWD can be inserted in certain circumstances (for example, if there is sufficient skin and soft tissue laxity to stretch and cover the implants, or if the surgeon is trying to close a large gap between the breasts).   However, problems can arise if implants are too large for the breasts, like rippling, sagging or other issues.  Your own surgeon will be in the best position to advise you about the pros and cons of your particular implant choice because they have done a proper assessment.

James H. Rogers, MD · Answer

Many different factors must be considered when choosing the correct implant for a given patient. The base width (BWD) is an important one. Generally speaking, an implant this width or smaller will have adequate tissue coverage. The amount of breast tissue and body fat, and the laxity of the skin are factors that also greatly influence implant selection. If you have accurately communicated to your surgeon what your desired result is, trust them to make the correct implant selection.

Kenneth Hughes, MD · Answer

You do not need to have a narrower implant than BWD. The BWD measurement is merely a guide to help determine the width needed and the cc size options available. Open discussion between you and your PS is essential when choosing what profile will result in the desired look.

Pejman Aflaki, MD · Answer

Hello and thank you for the question and sharing your photo. I would not worry too much about these measurements. There is some degree of variability in terms of breast width measurement between plastic surgeons. It is not uncommon to have some difference between the breast width and implant base diameter and as long as they are close, you should be fine. Make sure your surgeon is board-certified and has shown you lots of examples of their work (before and after pictures of real patients with real results).Best,Pejman Aflaki, M.D.Johns Hopkins-trained double board-certified plastic surgeon

Sean Hill, MD · Answer

Thank you so much for submitting your question. 
When it comes to picking a breast implant there are several different methods and each surgeon may ascribe to a particular methodology. 
My personal preference is to take a patient's base diameter and use this as our 'ceiling' when it comes to picking an implant. The reason being is that if you go wider then you will result in having breast spilling out into the armpit or across the midline. Conversely if you go too narrow then you will not augment the entire breast footprint. Once we have picked the breast diameter we can adjust different profiles for certain looks as well as to get the volume desired. 
Now other surgeons use other methodologies to pick their implant out, so if you are concerned it may be worth chatting with your surgeon. 
Thank you again and best of luck!

Shlomo Widder, MD · Answer

Dear magical,   Thanks for posting your picture. From observing your picture you appear to be perky  small B cup size. You did not provide your chest circumference in inches, which is critical for the final cup size outcome. Let's assume that you are currently 34 small B cup size. 415 cc implants will bring you to 34 D +. If you are 32 small B , it will bring you to 32 small DD. Is this the size that you are looking for ?   In my opinion, based on being in practice for over 32 years and having performed breasts augmentation surgery on thousands of patient, there are only few important numbers in selecting your implants size - chest circumference in inches, current breasts' cup size , your desired breasts' cup size and implants' volume.    So, do not worry about the implants' diameter, since the liquid  implants will conform to the pocket shape.    Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical with nice upper slopes and natural looking.                      Best of luck,                                    Dr Widder

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph. Each surgeon measures their BWD differently so expect some variability.  That said it is typical to be with a centimeter or so between your BWD and implant diameter for the best results.  Hope this helps.

Can an implant be larger diameter than BWD?

Answers (18)

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