Which Implants Are Right for Me? Small Bwd, but Want Natural Look. Sil Unders?

I am 31, 5'7, 110 lb' and my rib cage is around 27. I am a 32a right now. I have a fairly "bony" structure after 4 kids. I want to look natural! with a bwd of up to 11' i only have a couple of choices...I narrowed it down to 2... The mod plus 235 ( proj 3.6) or the high prof 300(project 4.5). These options could not be more diff. I found a style 40 (260) with 11.2 and project 3.8...but it's bigger than 11, and says for special cases. I am weary of high prof..I dont know what to do.

Doctor Answers 8

Choosing implant size

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Thank you for your question and your diligent research but what do you need your surgeon for? This is something that your surgeon will most likely decide in surgery. Certainly they will need your input as far as the look you are going for etc, but the reason surgeons have intra-operative sizers are so you don't have to make this decision. Trust your doctor, thats why you chose him or her, for their expertise!

Good luck!

Atlanta Plastic Surgeon

Selecting the correct implants

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I applaud you on your research and decision processes. I do not use high profile implants in my practice and here is why: You cannot force the shape of an implant on the breast, if you do, then you will probably cause atrophy of the breast tissue, possible chest wall deformities (photos of same are in the recent plastic surgery literature) and tissue damage as the breast thins out. I do agree with going submuscular, I do not recommend going above the muscle in any primary cases. Generally, I like the moderate plus (style 15 Allergan implants), however, if the tissue envelope is very tight, then a low profile (style 10) works really well.

I would suggest reviewing your suggestions with your surgeon who can best evaluate your tissues and advise you best.

Mark D. Epstein, MD
Stony Brook Plastic Surgeon
4.9 out of 5 stars 243 reviews

Best Implant/Location For Natural Look

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I think that you are on the right track.  I feel that all patients (especially patients with A cups) are more likely to obtain a good result which mirrors a natural breast if they select siliconew implants and have them placed under the pectoralis muscle.  I would use a moderate profile implant as well.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Selecting a breast implant: Beware of high profile implants

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You are quite correct to beware of high profile implants.  I almost never use them in my practice.  In my opinion one of the biggest mistakes commonly made in breast augmentation is underestimating the true base width of the breast.  Almost all women who desire a natural look will benefit from an appropriately selected low profile implant placed appropriately.  I exclusively use the subfascial plane with a technique that I call 'cold-subfascial augmentation.'  This trechnique allows me to shape a round low profile implant into a projecting tear drop shape. The fascia supports the implant and helps prevent stretching and aging.  High profile implants almost always result in a long and narrow appearing breast with an 'augmented look.'  I hope this helps!



All the best,


Rian A. Maercks M.D.

Implant choices

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Without an exam it is hard to say what would be best for you.  In general, I use HP's quite often for narrow framed patients.  

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Selecting breast implants

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I think you are trying to make a decision that is best left to your plastic surgeon.  Although we use numbers and measurements to decide on the correct range of implants sizes for any patient that is not the only determinant we use to make that decision.

In my opinion, the role of the patient in the breast implant decision making process is to explain as precisely as she can what she would like to look like after the procedure. Many patients use photos to show me what they like and what they do not like.  I do not believe photos are a reasonable way for patients or the plastic surgeon to decide on implant size or style.

In my opinion, the role of the plastic surgeon in the breast implant decision making process, is to tell the patient that her goals or desires are reasonable or not.  Unfortunately, we cannot disregard the individual anatomy of the patient and place an implant that is not compatible with the patient's size and shape and soft tissue characteristics in an effort to reach the patient's desired appearance. There is a reasonable range of implant sizes and styles for each patient, in some cases there are just a few ideal choices, in some cases there are quite a few. In either case, the ideal implant will yield a certain size and shape and this will have to be accepted as "ideal" for the patient given the starting point.  To disregard the patient's anatomy and size and shape and soft tissue means forcing the patient's anatomy to conform to the implant which has been shown over the years to be unsatisfactory and unfortunately when this approach is taken the patient may require additional surgery to address the problems that result.

Thank you for your question and best of luck.

Ralph R. Garramone, MD
Fort Myers Plastic Surgeon
4.8 out of 5 stars 68 reviews

Selecting breast implants

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I very much agree with the last post.  It can be very difficult to assess the most appropriate implant for your chest given a few measurements without assessing your tissue.  But, you are thinking the right way about implants in general.  It is important to respect the tissue that is there and particularly the chest width.  If your surgeon feels that it is appropriate, the high profile implants can be a good choice to attain a certain volume and appearance.  I find that they often work well in taller women with narrow chests.  In the volumes you are looking at, I don't think that you have to worry about looking "over done".  It may be hard to assure you of the breasts appearing or feeling totally natural depending on how much breast tissue you currently have.  Once again, an exam and consult with a board certified plastic surgeon will be so helpful in directing this conversation further.

Which Breast Implants Right for Me?

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Thank you for the question.

With all due respect, I think you are going about things incorrectly.  You are putting too much pressure on yourself to select breast implants that will achieve your goals;  In my opinion, this should  not be a decision made by a layperson with very little experience with breast implants.

I would suggest that you choose a well experienced board-certified plastic surgeon to do your breast augmentation for you. Make this decision carefully based on training, experience, and ability to achieve your goals.

Once you have made this decision, communicate your goals clearly with him/her. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural”  etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.

Although potentially helpful, I do not think that the use of pre-operative sizers and/or “rice test”  is a precise enough way to communicate goals.  As you can imagine, a breast implant size or placed on the chest wall will not necessarily create the same look as the same size placed on the rib cage ( below the pectoralis muscle).

In my opinion,  online consultation regarding breast implant sizing cannot be very specific to your situation and can potentially be misleading/confusing...

Best wishes.

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.