Follow-up Question - What would be the best size implants and profile for breast with a 9cm bwd?

I want 450cc but at a recent consultation a Dr told me that I should stay in the high 300's to low 400's cc with a high to ultra high profile. I have a large gap between my breast and I'm worried that this will leave them looking like tennis balls on my chest. I know I won't be able to get the gap fully closed but is there any way to get a nice round look with high projection? Also I'm really aiming for the nice even projection with under boob.

To see previous question, please click here. 

Doctor Answers 10

Best size and implants for you

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It is very difficult to determine the best size you will need (recommended based on your photos) or 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 300 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. The same process goes for just filling in the upper part of your breast without becoming much larger. 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 including silicone vs saline implant

 #breastimplant

Sizing Options

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Hello,


Thank you for your question. Unfortunately, "9cm" doesn't match the implant sizes you or your surgeon are suggesting. 9 cm is extremely narrow; less wide than most of the lowest BWD options listed in sizing catalogues. I suggest that you double check those details.

Having said that, your Plastic Surgeon will suggest implants which are suited specifically to your breast measurements while also considering the size you want. In order to remain proportionate/balanced, there will be a reasonable limit. My patients find it helpful to try on the implant sizers with a form fitting T-shirt in the office in order to get an idea of how they will look.


All the best

Follow-up Question - What would be the best size implants and profile for breast with a 9cm bwd?

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With your history of weight loss and after reviewing your previous post's photos, I feel that you have large potential gain if the best implant size is selected at the time of the procedure while you're under anesthesia and "sizer" implants can be tested.  I personally find narrow diameter HP or UHP implants too unnatural looking and would not recommend them for you.  During the surgery I would place test implants to determine if your size goal could be achieved with or without a Benelli mastopexy to slightly raise and narrow your areolar diameters.  Allow your surgeon to make the best choice for you based on the actual appearance of your breasts during the procedure when your size, shape and contour can be most accurately determined with each individual size implant.  Best wishes and regards,


Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca 



Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Implants

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Choosing the right implant of you requires an exam in person. Best for you to be seen for evaluation and a discussion of your goals.

Best size implants for a 9cm BWD

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Thank you for sharing your question.  Unfortunately without an in-person discussion as to your goal results. and measurement of key breast parameters, it is impossible to recommend an implant size.  I would advise trying on different implants in your surgeon's office in order to better visualize what size works best based on your anatomy.  Hope this helps.

Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision

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I appreciate your question.

The size of implant best for 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.

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

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon



Implant size

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Hello and thank you for your question.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

What would be the best size implants for me?

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Thank you for the question. Despite your good description of body type and goals, online consultants will not be able to provide you with specific enough advice to be truly helpful. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging)  as well as careful measurements (dimensional planning) will be critical.


Some general thoughts regarding "cleavage concerns" may be helpful to you and other young ladies considering breast surgery:


Patients undergoing breast augmentation should understand that their anatomical “starting point” will play a significant "role" in the outcome that they can expect with breast augmentation surgery.   If the patient starts out with a significant distance between the breasts, there are limits as to how close of "cleavage" can be achieved.  If over dissection (when developing breast implant pocket) occurs in the cleavage area, with the goal being to achieve as close as possible cleavage per patient's request, patients may experience significant problems such as breast implant displacement (medial  malposition or symmastia) and/or significant breast implant rippling/palpability.  Obviously, these types of problems may require revisionary breast surgery to correct.  



Also, keep in mind, that each nipple/areola complex must remain centered on each breast mound after surgery.  Again, careful dissection of the breast implant pocket and appropriate selection of breast implant size/width/profile will also play a role when it comes to how close the cleavage area will be postoperatively (and the overall shape/symmetry of the breasts). Careful measurement/dimensional planning plays a big role in this regard.

 

 

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:



1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.



2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, 

I have found that the use of words such as “nice round look” or "C or D cup” etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.



3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes. 

What size implant if right for me?

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There is no one correct implant size for any patient. There are ranges of sizes (and projections and shapes) that will give good results for any particular individual. Without seeing your photos and having the exact measurements, it is impossible to determine what implants would be best. But generally, I give patients a range to choose from, and we try to meet the patient’s objectives in terms of size, as long as it can be done safely with a good aesthetic outcome. You should listen to your surgeon. And he or she should listen to you!

Neal Handel, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 37 reviews

Breast Augmentation - Size Selection

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Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

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.