pectus carinatum (I think) and two totally different breast! Can this be fixed with 500&550HP silicones?

So as you see in the pic I have not only a bigger areola and right breast but the bone sticks out on the right side too- plastic surgeon using pretty much only the axis three3d machine to judge what size meets my goals (hide sticking out bone and have natural big looking breast that sag and jiggle like real boobs... Is 550 (for small side) and 500 for the right too big I'm 5'7 130 VERY MUSCular and I think it's the allergan style 20 HP silicones... BWD might be 13.4.... Really don't want a gap between my boobs from implant being too narrow :/   

Doctor Answers 6

Breast Augmentation Usually Camouflages Pectus Deformities

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Breast augmentation will likely camouflage your pectus deformity to a large degree. The larger 500/550 implants will help in that regard. Be aware that you will not likely end up with cleavage without a bra given where your breast mounds are now. Also the larger right areola is going to be more noticeable afterwards so you can either have a periareolar reduction on that side with your implants or wait have it done later after the breasts relax and the implants settle into their final shape.

Two totally different breast! Can this be fixed with 500&550HP silicones?

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That there is asymmetry is clear from the photo. How much I can't tell. I find that having a patient try on implants is a useful way to choose size, particularly in the setting of asymmetry. 

GIven your breast width, the implants suggested seem ok by that criteria. Whether your skin and muscle will stretch enough look natural, and whether you wish to be that large is another issue. , and only with an in person exam would a surgeon suggest that that size is ok. 

In terms of gap between the breasts, there is one now, and there will be one with implants. The breasts are where they are and will not move. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Breast surgery

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Nearly all woman have chest wall, rib, clavicle or scolosis leading to chest wall and breast asymmetery when examining standarized photographs. A breast augmentation and/or mastopexy may "camouflage" these deformities, when done skillfully, (or it could accenuate them if not identified and accounted for by your surgeon  pre-operatively) but it never "fixes" them, as the boney abnormality exists even after augmentation. Your left breast will look fantastic with a dual plane release and large high profile implant if you desire going that large. I agree, the right will likely require a circumareolar or circumvertical lift to acheive symmtery of areolar size, and tighten the inferior skin envelope to prevent loose skin from hanging off the bottom of the implant. Nobody likes the gap or "canyon cleavage" and in my opinion is a direct result of most surgeons undersizing implant width. The width of a 20 500 is 13.0cm and 550 is 13.4cm so you will introduce a width asymmetry in an attempt to balance the overall volume. This is an important point as you may introduce a new difference between your breasts that may or may not be desirable.

Fixing Pectus Carinatum with implants

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If truly you do have a carinatum, it can be fixed with implants. The type of implants will be determined by the width of your breast. With a width of 13.4 you are cert a candidate for both HP and Moderate plus. Depending on what size you want to be will determine how many cc's. The right breast has a larger areola and slighlty more ptotic( droopy). So a small cirumareolar lift may have to be done on the right to match. The best thing to do is talk to your surgeon so you know exactly what to expect and go over all of your concerns pre-op. I hope this helps.

Dr C

Ritu Chopra, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 34 reviews

Best Breast Implant Size/ Profile for Me?

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Thank you for the question and picture.
 As you can imagine, despite your good description of body type and goals, it is not possible to give you precise  advice online.
 The best online advice I can give to ladies who are considering breast augmentation surgery is:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural”  or “D cup” etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

I hope this (and the attached link) help.


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From your photos it appears that you have two totally different breasts.  If you tried on these implants and are happy with the size then go for it.  Personally, I think 500/550 appears a little too large.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.6 out of 5 stars 37 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.