Recommended implant size for 32A/AA, 5ft, 11.2 diameter, very petite? Do you all follow the implant sizing chart? (Photo)

Question

Still torn between 295cc & 325cc. Went back to my PS to confirm his choice of 295cc. He showed me the Nattrelle chart (attached) where 11.25 chest diameter can go to max of 295cc, whilst 325cc is for 11.5 diameter. But looking at the reviews of a lot of the ladies in here with similar size as mine and went bigger than 325 actually looks amazing. Do you all follow the chart?What do you suggest I have for my size?Will dual plane make it look smaller?I have attached my wish boobs too,many thanks!

Marshall T. Partington, MD, FACS · Answer

I do
not follow the implant sizing chart as a guide for what is best for the
patient. The sizing chart tells me everything about the dimension of the
implant. Then it is an important conversation with my patients about the look
they want and applying the different dimensions to achieve that look. In other
words, the number of cc's in the implant, although important, is not the
overall picture or decision making tool. In my process of consultation, I have
patient's try on each prospective implant in a bra to determine the look. In
your case, you have a very delicate torso and restricting the base width of the
implant will be important common emphasizing projections so as to not leave too
much lateral fullest and make you look heavier or matronly compared to your
athletic frame. I would venture that a high-profile implant, round and textured
would be lovely. I personally would approach your breasts by placing the
implant over the muscle for a quicker recovery and to avoid animation deformity
when you twitch your chest muscles that make the breast which if the implants
are under the muscles. Also, your cleavage is better defined with an over the
muscle implant.

Goretti Ho Taghva, MD, FACS · Answer

Hello April09, thank you for your question.  Most patients get anxious about determining the correct size of implants for their breast augmentation.  It is true that the general guidelines on picking the size of implants depends on the breast diameter. However, there is some wiggle room depending on the patient's desire, their soft tissue envelope (elasticity, skin quality etc.) What I usually do is to order a few different sizes, and place sizers during the surgery to determine the final implant size in the operating room.  If you trust your plastic surgeon's aesthetic sense, you should trust that he/she would pick the right size for you after you communicated with him/her your wishes during the consultation. Also dual plane should not make your breasts look significantly smaller.  Best of luck!

Austin Hayes, MD · Answer

It's a good question. The difference in diameter between the two implants is 2.5 mm. This is a small difference. Many surgeons would be willing to place the 325cc implant for you.If you desire the 325cc implant, make sure you talk to your surgeon so that can discuss your preferences.

Vincent N. Zubowicz, MD · Answer

In my own practice I would gladly place the 325 cc implants. Choice of profile would depend upon the dimensions of your chest.

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the best implant 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 implants:

Lewis Albert Andres, MD · Answer

Hello! Thank you for your question. In general, implant size does not correlate with bra cup size. The cup size itself will vary from manufacturer to manufacturer as well as who is doing the actual measurements. Thus, cup size is never a reliable indicator for your breast size. I typically encourage my patients not to communicate her desires in cup size but more on the actual look and appearance. Good communication between you and your surgeon of your expectations is warranted - choosing your surgeon wisely is the first step. Discussion of your wishes and having an honest and open dialog of your procedure is mandatory (e.g, implant type, incision, placement, lift, etc). I have found that photographs brought by the patient is helpful to get a visualization of the appearance you wish for in terms of size, shape, fullness, etc.  A preopertive sizing kit is helpful in my practice. In addition, your surgeon's pre and postoperative photographs should demonstrate a realistic goal for you. Once this has been accomplished, allow your surgeon to utilize his/her best medical judgment during the procedure to finesse the best possible result for you after preoperative biodimensional planning and fitting the right implant for your breast width.  Both sizes seem reasonable given your stated body size and measurements - most women always state that they wish they chose the larger size.  Hope that this helps! Best wishes for a wonderful result!

Jaime S. Schwartz, MD, FACS · Answer

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

Kiran Polavarapu, MD · Answer

Breast measurements would help guide your plastic surgeon to help you chose the appropriate implants and the " look" you are going for.  There is no ideal correlation with volume of an implant and "cup size" due to many variables including the patient current breast volume and breast shape.

Tom J. Pousti, MD · Answer

Thank you for the question.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. You have also done a nice job, both in your description and with your goal photographs, communicating your goals here. I also think that your goal photos are realistic.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.Given your concerns/questions, I would suggest that you spend additional time (as much as necessary to make sure that you are both on the same page) communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.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 know words such as “natural” or "full C, small 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.

Ronald V. DeMars, MD (Retired) · Answer

This can all be pretty confusing when you are not used to making these decisions. For an artistic surgeon, the BWD is not what you have but what you want within reason for your anatomy. The difference between the two implants of 0.25 cm is 1/10th of an inch and basically meaningless. The projection can be of more significance.

Recommended implant size for 32A/AA, 5ft, 11.2 diameter, very petite? Do you all follow the implant sizing chart? (Photo)

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