Bony chest, narrow width, am I being unrealistic in my 'goal breast'? Please help! (photos)

Question

Hi, please see image of my goal, vs other which i find too small. I'm 35y,5'6" tall,110 lbs, band width 27.5 inches;BWD approx 11-12cm, bony sternum/chest and slight hollowed area/concavity. I'll go for submuscular silicone but not sure between 250 mod+ round - will this be too small? Any larger in this profile will sit too wide for my natural size; 300 HP round - highlight the hollow chest/too large? Or anatomical (size?!)? Are my 'goal breasts' unrealistic? Please help! Thank you so much.

Emmanuel Mallol Cotes, MD · Answer

Thanks for sharing your concerns with us. Based on the information you provide to us I recommend you a volume between 300-350cc with high projection under the muscle for a natural appearance. Kind regards

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  With your breast measurements, your goals seem reasonable.  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.   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

Aldo Guerra, MD · Answer

Hello Tamara.Based on the before and afters you have submitted, I don't think you're being unrealistic about the kind of results you can achieve. However, finding the right surgeon and having great communication about your goals are extremely important. Always see an experienced board certified plastic surgeon.Best wishes, Dr. ALDO

Ven Erella, MD · Answer

Thank you for your question. Your goal sounds reasonable and you are a good candidate for breast augmentation. Best advice is to see a board certified PS for evaluation and to discuss your goals.

Tom J. Pousti, MD · Answer

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 selection of plastic surgeon and 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.Having said that, my impression of your goal photographs is that the goal breasts may be somewhat unrealistic (bigger than what can be achieved without significant risk of complications).   Generally speaking, every patient undergoing breast augmentation surgery should understand that their anatomic starting point will limit the outcome of breast augmentation surgery.    In other words, a patient's starting anatomy will limit how large of a breast implant can be utilized safely. The use of a larger breast implant (than what is safely "allowed" by the patient's anatomy) can be problematic;  potential problems include breast implant displacement/malpostion issues ( such as bottoming out, lateral displacement, symmastia...)  and/or significant breast implant rippling/palpability.
 
***Given your concerns, it is definitely worth spending more time (preferably prior to the date of surgery) with your plastic surgeon to discuss further.  It will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.
 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 “natural” or "full 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 for an outcome that you will be very pleased with.

Bony chest, narrow width, am I being unrealistic in my 'goal breast'? Please help! (photos)

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