Will my high profile implants look smaller under the muscle than with the "sizers" i tried on in the office? (photo)

Question

i am 5'9.5" and 125 lbs and a 32A with wide shoulders and a narrow rib cage and waist. my surgeon said i have a "modelesque" physique and look. i cant find any pictures with my stats at all. i have chosen 350cc silicone implant and my doctor told me i needed to do high profile implants because of my narrow chest wall. what size will i be with 350cc silicone submuscular high profile implants? tried the size but was told they would look smaller under the muscle but more projection than the sizers.

Gary M. Horndeski, MD · Answer

At
size 32 A each 100 cc’s of implant corresponds to 1 cup size change.  350 cc implants will not fit retro-pectoral,
extrude inferiorly and laterally requiring revision.  The profile of the implant is irrelevant in the
retro-pectoral position since the muscle compresses it and determines the projection.  Unfortunately, your photograph shows you
lifting your breast higher.  It is
possible that you may benefit from a simultaneous lift.  There is a new technique called Breast
Augmentation with Mini Ultimate Breast LiftTM.  Using only a circumareola incision it is
possible to reshape your breast tissue creating upper pole fullness, elevate
them higher on the chest wall and more medial to increase your cleavage.  Through the same incision, implants can be
placed.  Aligning the areola, breast
tissue and implant over the bony prominence of the chest wall maximizes
anterior projection with a minimal size implant.  Small round textured silicone gel implants
placed retro-pectoral look and feel more natural, are more stable, less likely
to ripple or have complications needing revision.  Sizers do not accurately predict the implant
required.Best Wishes,Gary Horndeski, M.D.

Peter D. Geldner, MD · Answer

Clearly there are many factors to consider in picking the perfect size for your breast implants. But from my perspective, your size choice is the most important. If you're too small for your wishes, or too large, you will be disappointed. Using sizers under clothing is imperfect but it gets you in the ball park of the implant for you. When placed under the muscle, the actual implant usually looks about 10% smallr than when placed in a bra. So, if you like 300, go to 330. Your choice of 350 would translate into about 385.  I agree that based on your dimentions, you probably need a high profile implant to accomodate that volume.I almost always use sizers in determining the patient's choice, but I then use a three dimentional sizing system to clarify what the actual implant would look like. It's a real plus and unambiguously describes what various implants look like.I no way am I disregarding the parameters which my colleagues refer to. Skin laxity, thickness, muscle details all matter, but from my perspective, if I haven't delivered the look you seek, I haven't done my job. Good luck!

Rigo J. Mendoza, MD · Answer

Thank you for your questions and pictures.  To answer your question, yes implants under the muscle will project less than sizers put in a bra.  Having said that, sizers are an inaccurate method of determining final cup size.  Sizers in the bra don't account for the skin thickness, the elasticity of the skin, and whether the implants are placed above or below the muscle.I would recommend discussing moderate plus profile implants instead of high profile.  When you have a narrower chest wall, it is also harder to get a bigger (high profile) implant under the muscle.  You may want to get a second opinion also, that way you can get another point of view from someone who has examined you, not just on here.

Andrea Marando, MD · Answer

Thank you for your questions. There are several factors which have an impact on the final appearance and size of your breast, including thickness and laxity of the skin, thickness of the muscle, striae...Therefore the choice of the implant to achieve a specific size is an educated guess. The muscle will "flatten"slightly your implants and will require time to stretch to allow you to achieve the final projection. It might be a good idea to see your surgeon for a second consultation to clarify some points. Best of luck with your surgery.Andrea Marando

Benjamin Van Raalte, MD · Answer

My experience over 25 years is that the sizers always look a little larger than the implants for the majority of patientsThis is due to several reasons. I believe compression does make them look a little smaller and it is spread out, and patients also get used to the new look.I recommend that when patients try on our sizers they realize that if it looks just right or a little small, later they will feel it is a little small. If they feel it is a touch too big, then it will probably be just right.Remember, size is not the only consideration. We properly size implants by chest width, skin elasticity, and patient desired projection, and shape. That determines the size and our reoperation rate for size has been way below the national average.

Darryl J. Blinski, MD · Answer

In my practice I always good at least one volume size higher than the chosen one. So in your case over the internet I chose 400 cc HP implants..

Kenneth R. Francis, MD, FACS · Answer

Dear Wannabe,
Your plastic surgeon has probably matched the base diameter of your breasts to an implant size to achieve the cup size that you desire.  High profile implants might create a less natural appearance in your tight skinned A cup breasts.  Good luck!

Will my high profile implants look smaller under the muscle than with the "sizers" i tried on in the office? (photo)

Answers (7)

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