Can I use wider implant than my allowable chest area? (Photo)

Question

I am exchanging implant from MP to Low profile to have less fullness in the upper pole. My chest side measures 15cm. I’d like to maintain volume so my chosen low profile implant has550cc , 16.5cm-3.5cm. My surgeon will put internal stitches at the sides to fit the implant into the pocket. Do you see any issues with this since implant is larger than my chest? Will it bring upper pole higher again? Will this creat ripples? Will this create more cleavage (desired)? Will this turn nipples outward?

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question. There are many factors at play when choosing the right implant for you. The base diameter of the breast footprint and and implant diameter are two important variables to take into account. In general most surgeons don't lean towards choosing implants wider than the measured breast base diameter because then they will either have to either create a wider pocket (going into the axillary region) to make it "fit" properly, or have the implant possibly be "pushed together" by a smaller pocket. This may as you alluded create more fullness in other parts of the breast and may be more likely to have notable implant countours in thinner patients. The best advice is to seek a follow up consultation with your surgeon or have another consultation with a board certified plastic surgeon to confirm you measurements with a physical exam and discuss your options.

Daniel Barrett, MD · Answer

Dear Lisa Wu,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Jeffrey Lisiecki, MD · Answer

A lower profile implant may create more upper pole fullness for a given volume, because it is "taller" as it sits on your chest.  I typically do not recommend placing an implant that is wider than your chest base width, because it will violate the soft tissue support of the breast.  This may place you at risk for implant malposition and rippling.

Robert M. Tornambe, MD · Answer

I appreciate your concern, and I always prefer to select breast implants that have a slightly smaller base diameter than the chest diameter of the individual having the breast augmentation. This prevents the dreaded “side boob” phenomenon where the edge of the implant can be seen in the arm pit. if your surgeon plans to suture the pocket, that could mean that your pocket has widened and needs to be sewn back to appropriate proportions. If you have any doubts, it may be a good idea to obtain a second opinion by another board-certified plastic surgeon in our area. Good luck.

Zoran Potparic, MD · Answer

We usually plan our implants slightly smaller than breast base/footprint to avoid symmastia or lateral displacement. However, your surgeon may have certain reson to select that particular implant? Only on the basis of in person evaluation and discussion about your goals, a board certified plastic surgeon can make decision about profile and volume of implant. Hope this helps.

Shana Kalaria, MD · Answer

A 550cc low profile implant with a base diameter of 16.5 is a terrible and uncommon implant. It is too wide for most chest walls and will make you look top heavy, yet flat. Additionally, the pocket will likely not accommodate that implant as the pocket will not be wide enough, so the implant will fold on itself and likely will fail faster than other implants leading to rupture. Additionally, that implant is like a pancake, it will not be able to provide the structural support to give you a nice round breast shape. Your wish for less superior pole fullness, but more cleavage is a bit unusual as well. Going from moderate to low profile will not achieve this. You should meet with a board-certified plastic surgeon and have a thorough discussion about implants. Good luck!

Camille Cash, MD · Answer

Small differences between implant width and breast width are typically okay, but when you exceed it too much you could risk the look you are wanting.  You may want to consider a smaller implant that fits the breast space better.  I've included a video on implant selection that I hope you find helpful.

Connie Hiers, MD, FACS · Answer

The 550 cc implants is a very large and heavy implant and you will sag more with time. I would suggest going down in size so it will be more comfortable.

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