Best BA option to help small breasts with a wide sternum and outward oriented nipples? (Photo)

My BA is scheduled for the end of December and I have an appointment with my surgeon coming up to discuss these things but I'm really stressing out about it and wanted to get some more opinions in the meantime. So far we've decided on 350cc to 400cc silicone under the muscle textured implants. I want my breasts to be rounded out and don't want the BA to emphasize my wide sternum/outward oriented nipples to the point where they look weird. Any reference photos would be helpful! Pics from consult.

Doctor Answers 9

Implant options for small-breasted body type

Hello, it is not possible to give detailed advice on the optimum implant type and volume based on a photo alone.  From the photo provided it appears that your body frame is very petite and breasts are small so I tend to be conservative with my implant recommendations to ensure there is enough breast tissue covering them.  However, if you have already had a consultation with an experienced certified plastic surgeon and are seeing them again for another discussion, it sounds like you are on the right track.

Toronto Plastic Surgeon
5.0 out of 5 stars 63 reviews

BA Options with Wide Sternum and Outward Oriented Nipples?

So you are already a little ahead of the game by recognizing that you have an anatomic variation in your chest shape, breast position and nipple orientation. It will be very important to have an in depth conversation with your surgeon about your anatomy, and how he/she will address your specific circumstances. Yours is not a straightforward augmentation procedure, and a number of factors including implant size and profile, type of implant surface, and precise surgical technique can all have a significant impact on the outcome of the surgery. 

A couple of particularly important points would be to not too aggressively try to narrow the space between your breasts because this could result in a visible medial edge of the implant and outward rotation of your nipple. As your surgeon has suggested, I would recommend using a textured surface implant. Because your breasts are positioned more lateral on your chest wall where it slopes downwards, your implant will have tendency to drop to the outside.Textured surface implants, when properly placed, should adhere to your tissues and they will have less of a tendency to drop to the outside over time.

Braden C. Stridde, MD
Kirkland Plastic Surgeon
4.8 out of 5 stars 53 reviews


Thank you for your question and photos and remember that augmentation will
make your natural breast larger not change your overall anatomy.  That said you should get an excellent result!

Dr Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 61 reviews

Breast Enlargement with Wide Spread Nipples

As you're aware your anatomy presents some challenge.  Centering your implants too close too the sternum will make your nipples point outward and positioning the implants laterally will have less effect on your cleavage when not wearing a bra.  The larger the implant (I would recommend mid or mid+ profile silicone smooth) the wider its base but going too large may make you look unnatural and over augmented.  Allow your surgeon to use his judgment in implant selection during the procedure based on what size appears to give you the best aesthetics overall and understand that you're likely to need bra support to get you the ideal cleavage.  Placing too large an implant can be damaging over the long-haul and should be discouraged.  Enjoy your results....

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews


I would prefer moderate plus silicone implants for your case. A Board certified plastic surgeon in your area will help you make best decision 

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 42 reviews

Best BA option to help small breasts with a wide sternum and outward oriented nipples?

Your preoperative shape has the greatest influence on how you will look post augmentation. You can still achieve a beautiful result, but you cannot change your overall shape, meaning that you can't make your result look like someone with a narrow breast bone and breast that point straight ahead.
I find that using low or medium profile implants with a diameter that fits your frame produces more natural looking breasts that mask the prominence of the sternum and ribcage work better than high profile implants in your type of anatomy.
Good luck

Don W. Griffin, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 72 reviews

Dimensional Planning and Pre-op op breast anatomy/appearance important in #breastaugmentation results!

So often overlooked, is what you start with is the single largest influence in your result. So you're already ahead of the game by recognizing your anatomic starting point. In general wider cleavage is less obvious with less aggressive profiles. Imagine a wide valley, versus the grand canyon. Steep canyon walls far apart of more impressive and obvious. I would likely recommend dimensionally sound mod+ or SRF and steer you away from high profile if you were my patient. I attached a link with my galleries of hundreds of patients to see what similar before pictures looked like after surgery in my practice. Best of luck.

Evan Feldman, MD, FACS
Texas Plastic Surgeon
5.0 out of 5 stars 86 reviews

Breast implants

Thank you for your question and photos.  If you have made sure to choose a surgeon who is board certified in plastic surgery and is an expert in the breast augmentation, then I suggest trusting in his or her opinion as to what would be best.  Please be sure that you have realistic expectations from surgery.  For example, it is probable that your nipple position and gap between your breasts will be noticeable after surgery.

All the best,

Dr. Results
Miami, FL

Jose M. Soler-Baillo, MD
Miami Plastic Surgeon
4.7 out of 5 stars 92 reviews

Best BA option to help small breasts with a wide sternum and outward oriented nipples?

Thank you for the question and pictures. You are correct in that a patient's anatomical “starting point” will play a significant "role" in the outcome that can be expected with breast augmentation surgery. In other words, helping patients achieve a sense of realistic expectations is an important part of the preoperative process. Having said that, with careful   pocket dissection and careful selection of breast implant size/profile, I expect that you will have a very nice outcome with breast augmentation surgery.

Ultimately, careful dimensional planning/measurements, careful communication of goals, careful execution of the procedure (including selection of appropriate type/size/profile of breast implant) will be important.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) 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 are 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. In bra sizers can be useful communication tools also. I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during the communication process.
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 ( after the use of temporary intraoperative sizers).

I hope this, and the attached link (dedicated to breast augmentation surgery concerns), helps. Best wishes for an outcome that you will be very pleased with.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 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.