Rules for Matching Breast Implant Diameter to BWD?

Question

How closely do you try to match the diameter of the implant to measured BWD (Breast Width Diameter)?  Within .5cm? 1.0cm? Do you ever go over, and if so, by how much?  What other factors affect the match between Breast Implant diameter and measured BWD?

Farbod Esmailian, MD · Answer

BD is a good way to determine what implant size would work for a particular patient.  I do not like to go beyond the BD of a patient.  But this is not the only thing to consider.  There are many other factors involved as well as surgeon judgement.  It is not always as simple as a formula, but that is a good place to start.
Hope that answers your question.

Tom J. Pousti, MD · Answer

Thank you for the question.

	The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size.  Much of the final &ldquo;look&rdquo; achieved after breast augmentation surgery  depends on several factors: 
	1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation &ldquo;look&rdquo; will be optimal.
	 2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.
	 3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result. On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants. Other differences involve how the breast implants are filled. Saline implants are filled after they&rsquo;re implanted, so saline implants require a smaller incision than prefilled silicone breast implants. On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers&rsquo; saline-filled breast implants are considered investigational. As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
	 4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of &ldquo;goal&rdquo; pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as &ldquo;natural&rdquo; or &ldquo;C cup&rdquo; or "fake looking" or "top heavy" 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. By the way, the most common regret after this operation, is &ldquo;I wish I was bigger&rdquo;.
	 I hope this helps.

Otto Joseph Placik, MD · Answer

There are many factors that go into the decision making process and cannot be boiled down to a simple formula. Generally I am willing to go up to the BWD if the paitient has more than a 1.0cm skin pinch as well as a relatively modest amount of breast tissue. In exceptionally thin patients I may go no larger than 1 cm less than the BWD to minimize visibility of the implant.

Steven Wallach, MD · Answer

There is no hard and steadfast rule regarding base diameted and choice of implants but it does guide me to decide how wide the implant will look on the chest.

Nirav Savalia, MD · Answer

I think the diameter of the breast is a key factor in choosing an appropriate sized implant.  All other measurements aid in this decision, but the main goal is to choose an implant that will "fit" in your current breast. That said, I stay as close to the breast diameter (within 0.5 cm) without going larger. Ultimately, it is the patients goals and willingess to compromise that yields the final implant size chosen.

Rules for Matching Breast Implant Diameter to BWD?

Answers (7)

Answer: Chest anatomy

Answer: Chest anatomy

Answer: How to choose an appropriate sized breast implant

Answer: How to choose an appropriate sized breast implant

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Everything you need to know about Breast Implants

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Rules for Matching Breast Implant Diameter to BWD?

Answers (7)

Answer: Chest anatomy

Answer: Chest anatomy

Answer: How to choose an appropriate sized breast implant

Answer: How to choose an appropriate sized breast implant

Browse related questions

Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.