How do you determine implant size with a breast lift? I have wider breasts (14.5) and am concerned implant will be too narrow.

Question

I don't understand what at the possible effect of a smaller implant on a wider pocket.

Daniel Barrett, MD · Answer

Dear hanak,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Keshav Magge, MD · Answer

Hi- thank you for your question.  Implant profile is determined by the size you want and your chest wall diameter.  You ideally want the implant to fit the chest wall.  If its too wide, you get side boob.  If its too small/ narrow- the implant doesnt have as much effect and can float in the pocket under the breast.  It won't have as much effect and can shift in the sub pectoral pocket.  Its a goldilocks approach of finding the implant of best fit. Best to speak to a board certified plastic surgeon. All the best,

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Eric Swanson, MD · Answer

For patients with a wide chest, the moderate plus profile implant works well. Of course, the implant volume depends on your existing breast size and the desired size. When doing a lift, breast tissue is removed from the bottom of your breast to help cinch the lower pole and correct sagging, so the breast is made a little smaller just by doing the lift. (A vertical lift is best. Other methods such as the anchor scar method tend to leave lower pole tissue behind, making the lift less effective). The most common implant shape in my practice is high profile to avoid "side boob." Usually, women with a broad chest select large implants to fit their body frame and provide a good cleavage.

Daniel Butz, MD · Answer

Base width is an important consideration for breast implant selection. We don't want it too wide or too narrow. But there is some wiggle room one way or the other. A breast lift can narrow the breast a little - depending on technique, anatomy - so a narrow implant is reasonable. If you have more breast tissue that is frequently subtracted from the base width measurement. 
So it is complicated and a bit subjective.

If the implant is too narrow - it won't fill in the cleavage very well or the upper pole enough. The implant is as tall as it is wide. If it's too wide - it can give too much side boob.

If you're unsure of your implant choice talk to your plastic surgeon - they should be able to adequately explain why they're choosing that implant for you and if it's worth it with your lift. 
Or get a few second opinions from board certified plastic surgeons. 
Good luck!

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs or told us your bra size. However, if you are size 32 or 34, each 100 cc of implant corresponds to 1 cup size change. If you are size 36 or 38, each 200 cc of implant corresponds to 1 cup size change. If you are breasts are wide then they are descending inferiorly and laterally and lying more on your side than anteriorly. I recommend a breast lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

Your concerns would be answered well and issues explained by an expert breast surgery surgeon. Go out on some consults when you're ready to have surgery.

Sean Fisher, MD · Answer

Proper implant selection is dictated by both your ultimate goals as well as your anatomy. Implants come in different volumes and projections. When we consider a set volume of implant, as the projection increases the implant width narrows. Conversely, for a given volume, a less projecting implant will have a wider base. The most important measurement needed for breast augmentation is your breast base width, as it is critical to have a implant width that matches your natural anatomy. An overly wide implant will extend beyond your native breast and will visible while too narrow of an implant will not fill out your breast in a natural manner. When selecting an implant I typically measure base width and then we go over different volumes and implant projections that closely mimic this to ensure a result that will fit your frame and match your goals. 
Sean Fisher Aesthetic Plastic Surgeon Seattle, WA

Connie Hiers, MD, FACS · Answer

The size of the implant is not based only on the width of your chest, but also your height, weight, and the amount and shape of breast tissue that is present.

How do you determine implant size with a breast lift? I have wider breasts (14.5) and am concerned implant will be too narrow.

Answers (9)

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