What exactly is my BWD from these photos? (Photo)

Question

I'm a bit confused on my BWD as these pics measure differently. My PS recommends a 339CC mod+ implant that measures 12.4cm. He thought the 371cc might be too wide on my chest and create too much side boob, which I was trying to avoid. If I want a natural look for my body type (5'5",125lbs) which would you recommend-339 vs 371? 4 consults and they varied from 339-400cc??!! Surgery in 1.5 wks & I'm panicked. If I go too small (w/ 4cm gap) it might make my breasts look so far apart!? Any advice?

Michele A. Shermak, MD · Answer

Hello!Have you tried on implant sizers to get an idea of what the implants look like on you? The difference in volume between the implants  if they are both moderate plus in the same line - sounds like Allergan- is to fill out your chest width differently. The fullness/projection off your chest is likely a minimal difference between the two. With sizing, the 2 implants would look minimally different, if at all different.It seems you can go a size up from the 339 to fill out your chest width and get better cleavage. I would recommend you determine who your surgeon is going to be - whom you feel most comfortable with - and meet one more time to discuss your concerns. You should be comfortable with the plan, not anxious. Part of your comfort will include your trust in your plastic surgeon. I use sizers during the actual operation to simulate the result before committing to an implant and it may be that the 371 fills your chest out better. If you are unsure, you should feel comfortable with your surgeon's operative plan once you narrow down the sizes and discuss your aesthetic goals.Good luck!

Jerome Edelstein, MD · Answer

Hello,Everyone will have a limit for how large their implants can be and still create a proportionate, natural look. Whatever your base width is will determine what implant diameters are ideal. The difference in volume between the two you are mentioning is not huge. I recommend that you talk more with your Plastic Surgeon and try on the sizers with a form fitting t-shirt if you can. this will give you an idea of how the volume looks/feels on your body. I recommend that you let that and your Plastic Surgeon's advice guide you- not numbers of CCs.All the best

William Andrade, MD · Answer

Hello, I can't actually make out the BWD on your photos.  I would recommend speaking to your surgeon to make sure the Vectra BWD closely matched their own BWD.   Sometimes there is a discrepancy.

Christian Subbio, MD · Answer

As others have mentioned, the difference between the 2 implants you mention is quite small.  Not only is the base diameter only half of a centimeter (I recommend looking at a ruler to see the actual length of this) but the difference between the 2 implants his only 32 cc.  32 cc may only end up being about 5% of the combined volume of the breast and implant after augmentation.  As you can see, the difference between these 2 implants is very subtle and unlikely to cause very significant differences in your ultimate result.  The difference between it is where for the expertise and experience of your chosen plastic surgeon matters.  He/see will likely have multiple implants available in the operating room in the circumstance that he/she feels the need to go larger or smaller.  When I find myself considering between 2 so very similar options, I often go with the larger of the 2 because it is more likely that a patient will regret having gone to small than too large.  I hope this helpsbest of luck!Dr. Subbio

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The size of implant best for you is dictated by your
chest wall measurements.  Once we determine that we can choose the profile
based on what you want or need to achieve.  If you are seeking a natural look,
then the diameter of the implant should be equal to or, more ideally, smaller
than the width of your breast. The breast width is a measurement of how wide
your breast is at the base, which should be measured at the level of the
nipple. Choosing an implant that is smaller in diameter than your breast width
will avoid the "side breast" fullness that is often associated with a
more artificial appearance.  Other than that, you should choose the
implant based on volume, not on the dimensions of the implant. You should
choose a board certified plastic surgeon that you trust to help guide you in
this decision.

Silicone will give you a fullness at the
top (upper pole fullness).

Silicone implants come pre-filled with a
silicone gel and are the softest implant available. They feel more natural,
which makes them a good option for women with less natural breast tissue; but
they require a larger incision. It may be more difficult to realize if this
type of implant has ruptured, so it is important to monitor them with annual
follow-up visits. Additionally, because this implant contains a more liquid
silicone (less cross-linked), if this implant should rupture, it will leak only
into the scar capsule formed around the implant but may cause some discomfort
or implant distortion.

Anatomic gummy bear implants might be a
good choice to give you volume.

These highly-sought-after, anatomic
implants offer a look that more closely resembles the natural silhouette of a
breast, and, therefore, are a very attractive option for individuals seeking a
natural-looking, aesthetic primary breast augmentation. Additionally, these
implants are an especially excellent option for patients undergoing restorative
or corrective breast surgery because they provide more stability, shape, and
reduced incidence of capsular contracture. Compared to other types of silicone
gel implants, the silicone in the cohesive gel implant is more cross-linked;
therefore, should the implant shell “rupture,” it maintains its shape and
silicone does not leak.

During your breast augmentation
consultation, you should feel the different types of implants available, and
try on various implant sizers in front of a mirror to help you to get an idea
of how you will look following the surgery. You should also bring pictures of
the look you would like to achieve, as well as a favorite top to wear when
trying on implant sizers.

The best way to assess and give true advice
would be an in-person exam.

Please see a board-certified plastic
surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Deborah Ekstrom, MD · Answer

You are suffering from "analysis paralysis".    The difference between the implants is about 6 teaspoons or 2 tablespoons (think about the amount of vanilla you put into a cookie recipe). It is unlikely that you will create a secondary deformity of some kind with the smaller implant and it is very likely to look lovely.  Go with your doctor's recommendation....after all he/she is the one who examined you and will be doing the surgery and the one who went to school for a long time to gain expertise that you can't possibly duplicate by searching the internet (or asking doctors who have not examined you or listened to your wants and needs at length).Time to give up control and be peaceful with your decision and depend on the guidance of your surgeon.Best wishes for a smooth surgery and recovery!

Douglas Taranow, DO, FACOS · Answer

Thank you for your question and for the photos.Every surgeon does things a bit differently.  While I do measure my breast patients to estimate the size and width of implant required, I do not soley rely on those estimates.  I place a sizer and fill it to evaluate how the breasts look and to adjust the cleavage and lateral fullness prior to choosing the proper implant.  I order several sized implants for each client as quite often, the pre-op evaluation size was not the sized implant I placed.Dont obsess too much.  I'm sure your Plastic Surgeon is quite experienced and he is the one you interviewed and picked.Good luck with your new breasts.Dr. T

Kenneth R. Francis, MD, FACS · Answer

Dear Mshu,The BD of a 371cc Natrelle implant is 12.9cm.  That is only 0.5cm or 5mm wider than the 339cc implant.  It is doubtful that this difference will create "too much side boob."  There are also other factors taken into account when determining an implant size and dimension, such as tissue characteristics, goals for projection, cup size and goals for cleavage creation.  Your breasts have a somewhat deflated, I would guess postpartum, appearance and would probably benefit from the extra 32cc of volume.  Good luck!

John P. Stratis, MD · Answer

I tell my patients to begin with the end in mind; i.e. what look are you trying to achieve. All patients have some
idea of the way they want to look. That needs to be transferred to the plastic
surgeon's brain. The Plastic Surgeon then has to determine how to get that
look.
I find that a great way to determine the right
size implants are as follows. 1.Have the patient try on the implants in a
stretch bra with a clingy top to obtain the look they want. The Mentor sizing
system is great for this
2.Have the patient show the doctor pictures of
how they want to look
3. Use the Vectra 3D imaging system for
simulation
4.The surgeon should be able to put that
information together to determine a general grouping of implant sizes and
styles. He will consider the size of the breast and the chest in his analysis.
He should also tell you the positives and negatives of going larger or smaller. The base width is important but there are many types of implants that will fit into the same base width. They differ with regards to projection. The shape of the implant and the stretch potential of the skin will determine how that projection will look in the patient.  
5. I also will encourage the patient to take
home implants and wear them around the house so they start getting used to them
6. I also encourage patients to choose the
larger size if they are stuck between two sizes. The reasoning behind this is
that almost all patients will say they could have gone bigger. What you don't
want to say is, "I should have gone bigger."
Given all of these measures, you may find that
you cannot get the look you are trying to achieve at all or only through more
than one procedure. Additions of a breast lift and/or fat grafting could improve the results. An experienced plastic surgeon, certified by the American Board of Plastic Surgery, should be able to let you
know what is possible and what is not possible given your present situation.

Steven Wallach, MD · Answer

If the photos are accurate the base width is measure with the white line that describes the dimension between 13-14 cms.  An implant in that ranger or slightly wider would be a good choice.

What exactly is my BWD from these photos? (Photo)

Answers (13)

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