150cc-190cc for subtle change with pectus carinatum? (Photo)

Dear Vanessa343Thank you for your question and photos!  The implant size is a difficult choice.  I would advise that you stay with the smaller size - and a lower profile , as your right breast is fairly lateral on your chest wall and the chest is angled lateral - relative to the left breast.With Warm RegardsTrevor M Born MD

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  You do appear thin, so a relatively small size implant is a good idea.  The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Thanks for your question. You should definitely pick an implant that you are comfortable with. Width is important, so that the implant fills the diameter of your chest and breast, but projection, how much you want to stick out is up to you. I always recommend you look at actual implant sizers on your frame before you make any decisions. I have included sizing FAQ below and I hope they help.Best wishes.

Hi vanessa343,

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. 
Implant profile is one of the important considerations to make. Many patients wrongly assume that the higher the profile the better. The truth is, the more profile (or projection/height) and implant has, the narrower its base has to become. This is associated with several problematic consequences.

The first issue is that the patient loses width and therefore cleavage of the breast. The second is the breast becomes more narrow and pendulous, often falling lateral and onto the side of the chest, and third, high profile implants have a higher risk of bottoming out because they exert more pressure on the inframammary fold than moderate profile implants.

High profile implants do have a role in symmastia repair (when I need to narrow the base width) but otherwise I try to avoid them.

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, MHA, MS

Certified, American Board of Plastic Surgery 

Member, Am. Society of Plastic Surgery

The difference in size of the implants is equivalent to somewhere between 1/4 and 1/3 of a cup size. After I discuss my patient's goals and measure them, we look at pictures of women with similar measurements with different size breast implants. My patients tell me that this process is very helpful in determining what size and style breast implant is right for them.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

You pose a good question.  I would urge you though to concentrate on the final appearance and not concern yourself too much with the exact number in cc's of the implant.  The most important thing you can do is see a board-certified plastic surgeon experienced in breast augmentation.  Appropriate measurements will be obtained and often the exact implant size can only be determined intra-operatively.  A number of factors determine the exact shape you want with implant size being just one of them.

Hello....there's a lot  going on in your situation besides the pectus excavatum. One  breast is slightly lower than the other and there is a slight  difference in volume.  Talk to your PS  about your situation so that you have a clear understanding of your desires and his goals.   150cc implant is very small and my guess is that after a few months, you may have wished to be made slightly larger. Look at the photos of your PS and find a patient who is similar to you to help you make a decision.

My initial thought, based on the description of goals, is to choose the smaller of the implant choices.  One question that might be helpful to patients in your situation: would you be more disappointed if you are slightly too large or slightly too small? 
My best advice: more communication.
It is definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.
Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
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. For example, I have found that the use of words such as “natural” or "A or B 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. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
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 helps. Best wishes for an outcome that you will be very pleased with. 

Choosing the right implant for you will require an exam in person. You can try a baggy test with the volume you are interested in to see if it fills the bra that you want to wear.

You have widely located nipple-areolar complexes (NAC's) and a relatively broad chest. Since the central breast bone is not at all peaked it is hard to support a diagnosis of pectus carinatum.  A more likely diagnosis might be Forme Fruste Poland Syndrome, a very (very) mild form of chest abnormality.To get the results you want I recommend seeing a surgeon who can provide a trial of sizers. You would bring a thin bra and a tight tee shirt to the office and then try on different breast sizers to determine the volume that would provide the fullness you want.  Based on the volume chosen we would choose from among the various styles an implant that fits your chest in the X, Y, and Z dimensions.  Due to the width of your chest I would hazard a guess that you would not be using a high profile construct, but I would defer judgement pending complete exam and measurement.Be sure you see a surgeon certified by the American Board of Plastic Surgery who can show you enough of his or her own photos to give you confidence in your expected results.  The video below will illuminate a few salient points.