Very large breast implant in a 11cm BWD woman. Any suggestions?

Question

I want to know why so many physicians tell their clients they can not put a breast implant with more Ccs base on their BWD ? When I see so many petite woman's out there with 800ccs on their first time ? How is that possible. I have a friend she just have her first BA she has a 12cm BWD and they put 800 Ccs on her !! With no after complications. She have only one kid, and never breast feed

Jerome Edelstein, MD · Answer

Hello,Thank you for your question. There may be an extra full projection, large implant for you- but it may not be 800ccs. It will take less volume to achieve the same large look that you want- because you are smaller. Plastic Surgeons can exceed your base width slightly depending on a number of measurements and factors, however exceeding a reasonable size can lead to serious complications. Your Plastic Surgeon will want to give you the look that you are after but also ensure a safe procedure and optimal results which last. I recommend that you seek board certified Plastic Surgeons with plenty of expertise in this area and let them guide you as to the best sizes to meet your needs. my patients find it helpful to try the implant sizers on the the office with a form fitting T-shirt.All the best

Kenneth Hughes, MD · Answer

While you may not be able to get an 800 cc, you can probably get a much larger implant than is being recommended.  Find a board certified plastic surgeon who has performed thousands of 
these procedures and has hundreds of pictures and reviews. Kenneth Hughes, MDBeverly Hills, CA

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.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. As implant size goes up, the amount of natural breast tissue you have goes down, and the less natural of a result you get. One technique to have a more 'natural' result while still having a large augmentation is to use shaped implants. That being said, this relationship still holds true and with bigger implants the final result tends to be more 'sculpted' or 'augmented' and more obvious or easier to identify even when in clothes. Choosing an implant is a complex process and I definitely recommend setting up a formal consultation with a board certified plastic surgeon that you trust to help guide you in this decision. I hope this is helpful.

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 plastic surgery.Best of luck!

Dr. Schwartz

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 plastic surgery.Best of luck!

Dr. Schwartz

Tim Neavin, MD · Answer

Base diameter is one measurement out of a few that plastic surgeons take into account.  Distance from fold to nipple is another.  Based on these two measurements, we can often find an implant that "fits" given a desired volume.  Having said that, in reality this doesn't always yield the pretties breasts.  But when implants exceed a reasonable "fit", things like bottoming out or symmastia can develop down the road.

Gerald Minniti, MD, FACS · Answer

Hello,Your dismay is not uncommon. There are many 'I have a friend...' stories, but most of the time there is a missing piece or its not quite accurate. I can assure you that there are limits, and exceeding those limits puts you at risk for either early or late complications. There's no magic here.  By the way, BWD is not the only or most important measurement used to determine soft tissue capacity for a given implant.Be careful.

Payman Danielpour, MD, FACS · Answer

Generally speaking I use tissue based measurements in sizing for breast augmentation surgery.  In my practice we stick to tried and true methods using evidence based medicine that will provide consistent results with minimal complications.  With that said I would be very hesitant to ever place an 800 cc implant on a primary augmentation due to the high likelyhood of complications in the future.

Robert M. Wald, Jr., MD · Answer

As plastic surgeons, our goal is to achieve the best possible results in every woman that we perform breast augmentation on. BWD is one to the parameters we use to pick an implant that will best suit her body frame. When we start to exceed the correct dimensions of the chest wall, the implant will start to bulge into the armpit and nerve injury can occur. Yes, we can place larger implants, but over time consequences from these larger devices may occur. Stretching of the breast tissue and bottoming out of the implant can occur several years later which may cause a secondary operation. Be sure to talk to your surgeon about these potential risks.

Curtis Wong, MD · Answer

and some will not because they feel they know what is best for their patients.  I prefer to think patients can make their own decisions as long as they are fully informed.  And yes, very large implants on petite people will eventually lead to problems down the road where a breast lift and reduction of implant size will be needed.  But if you were ecstatic for the time you had the large ones and can live with the smaller ones, is it worth it to you?

Sean Kelishadi, MD · Answer

Hello Zazzy and thank you for your question! I want to start off
by telling you what I tell many of my patients: Do not focus on cc's or bra
sizes as many women see their friend with "x" number of cc implants
etc and think that they have an idea of what they want. There is a lot that
goes into implant selection -- your breast volume, the amount of cleavage you
want to achieve, your base width, your nipple-to fold distance, whether you have had children before (as the breast tissue tends to be more stretched out), your rib shape/projection, etc. Without
seeing you and doing your measurements, it is difficult to assess accurately
your final breast size or shape. Please also keep in mind that when it comes to
bra sizes, most women are not accurately sized for their bras. Also, not all plastic surgeons measure base width the same.
The most important thing to consider is really the size and look that is
appealing to YOU with the implants you choose. Many surgeons have sizing models
whether using bras with implants or computer simulation. A breast implant is
a round object and has a certain diameter. Your base width on each side of your
chest will determine "how big of a ball" or what diameter implant you
can reliably go up to with a socially acceptable cosmetic outcome. The implant
will "augment" or increase the size of your breasts to an amount
acceptable to you and your surgeon. 
My patients will try on a sports bra and then we pick the implants based
 on
their measured breast base width. For example, if your base width were to support up to a 600cc implant, I would have you try on the 600cc 
implants in
the bra and then the 580cc or 550cc implants and afterwards select the 
implant
that made YOU the happiest. In reality, don't stress too much as this is
 not a
HUGE difference and should be the fun part of the process. For your reassurance, I would have you try on the 800 cc implants and so you could see for yourself what they would look like on your body -- most likely you will see that either a) they have no room on your petite frame and/or b) that they will not look the way you want. My best advice to you is to go with what 
is
acceptable based on your measurements and makes you happiest and make 
sure to
weigh the pros and cons of the options you are considering. You can also
compare the moderate profile with high profile implants and see which 
look you
like most. The profile of the implant will determine how much upper pole
fullness and overall projection you portray.  In my opinion, in a young 
patient like yourself, high profile implants give the breasts a 
nice shape for augmentation, but it depends on your preferences.
Make sure to seek consultation with a board certified plastic surgeon 
with expertise in aesthetic breast surgery who has experience with placing larger breast implants. I hope
this helps answer your question and if you are uncertain about the 
recommendations made by the surgeon you met with recently, I encourage 
you to get further consultations. I wish the best of luck to you. 
Sincerely,
Dr. Sean Kelishadi

Barry L. Eppley, MD, DMD · Answer

Breast base width is but one consideration to make in determining breast implant size. While just about any breast implant volume can be placed in anyone, the development of complications is often a long-term issue not just what happens in the first few months or year after surgery. Most plastic surgeons widely use the general rule of not placing implant volumes that exceed the breast base width because it is associated with a lower risk of long-term complications. As long as patients have been informed of what may happen with breast implant volumes that may exceed the breast tissue dimensions, then some plastic surgeons will be willing to allow patients to assume these risks.