Breast augmentation/lift with a barrel chest? Is a certain profile better?

Question

Information seems to go back and forth of this topic when i research.. I have a barrel chest where my chest sticks out, slightly forward up, closer to my shoulder/upper arm area. Are breast implants still possible with something like this? I fear that with my chest poking out my breasts will never look s they should.  Also is a certain profile better recommended for barrel chest ?

Kenneth Hughes, MD · Answer

Hello, thank you for your question. It is hard to tell without photos. I recommend that you schedule an email, Skype or in-person consultation with a board certified plastic surgeon for proper evaluation. Low profile breast implants above the muscle can camouflage a barrel chest.

Matthew J. Nykiel, MD · Answer

Hello and Great Question. I appreciate the time you are spending researching this procedure. My name is Dr. Matthew J. Nykiel. I am a Board Certified Plastic Surgeon, a Fellowship Trained Cosmetic Surgeon, and a Breast Augmentation Specialist.
Without photos its hard to determine what is needed, Having a barrel chest doesn't eliminate the possibility of correction,  I would definitely recommend doing an in person consultation with a board certified plastic surgeon who specializes in this procedure and who can go over your options with you.
I hope that helps! Best of 
Luck! Matthew J. Nykiel

Christopher V. Pelletiere, MD · Answer

Without pictures, it is difficult to say what may work best for you.  It is not unusual to encounter all different types of chest wall anatomy, and none of them should preclude a patient from having surgery.  The key is choosing the best implant to match up with your goals, and this can only be done with an in person consultation.  The best thing to do is to have a few consultations with board certified plastic surgeons and see what they recommend.  I hope this helps.

Thomas S. Taylor, FACS · Answer

There are many patients that have either Pectus Carinatum like you or the opposite problem termed Pectus Excavatum. In both cases a well-planned and executed breast augmentation procedure will provide a natural result and one that helps camouflage the sternal deformity. In your case, the limitation will be cleavage. With a Pectus Carinatum situation the natural breast and nipple are more laterally positioned.  Your anatomy will not allow the implants to be placed as centrally as you might like and implants have a tendency to move to the side over time. Therefore, it’s very important to not over expand the “side boob” area. I don’t think the implant type or profile matters much assuming good pre-operative surgical planning. I hope this is helpful!Thomas S. Taylor, MD, INC

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I completely disagree with opinions expressed below. What you are describing is Pectus Carinatum which is a particular chest shape. It is very common in which the sternum sticks out father than the rest of the chest. As a breast revision specialist, I am very sensitive to chest wall shapes. I find that higher profile implants are needed to compete and camouflage the protruding sternum. Best wishes to you.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person evaluation by a plastic surgeon to be measured and discuss your goals. After I measure and discuss goals with my patients, we then look at pictures of women with similar measurements with different size and style breast implants. My patients tell me that this process is very helpful in determining what size breast implant is right for them. 
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author                 
RealSelf Distinguished Hall of Fame Inductee

Donovan Rosas, MD · Answer

The difference between higher and lower profiles for a given volume is projection and for a given width is volume (with the high profile implant being greater in both scenarios). The moderate plus is the most commonly used profile in my practice. It allows for the most reasonable volume in a given BWD. In my practice, low profile implants are the least commonly used (widest and flattest). I will typically reserve high profile devices for smaller framed individuals or those seeking a less subtle more dramatic change (the opposite of natural). 
In general, the difference between a high and Mod (+), in reality, is very small (on the order of millimeters).  In my practice, I generally classify profile based upon patient preference. A higher profile provides a more dramatic look (size for size) vs. a moderate (+) profile which is relatively more subtle and understated. That being said the vast majority of patients will select a moderate + profile device (especially those seeking a more natural and subtle result).
I often find it is easier to decide on a profile (rather than a volume), this combined with BWD will determine volume. Trying to match a particular volume to a profile may lead a BWD mismatch. In my practice, smaller framed individuals do prefer higher profile devices. Ultimately, profile choice is a choice between more or less subtlety.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Verified Member
RealSelf Top 100
RealSelf Hall of Fame

Ronald J. Edelson, MD · Answer

The profile will not matter.   just be aware that the implants may fall more to the side when you’re not wearing a bra,

Nelson Castillo, MD · Answer

Thank you for sharing your excellent question.  Implants and/or a lift should be possible with your described shape, but I would seek out a series of in-person consultations in order to get the best recommendations.

Daniel Barrett, MD · Answer

Dear mhelmeczi,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Breast augmentation/lift with a barrel chest? Is a certain profile better?

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