I am petite, 5’1, 115 lbs, but have a wide ribcage/chest width, 12 cm. Second-guessing 375 cc HP decision. Thoughts?

Dear Jkriso,
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

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. 
On a smaller frame such as yours, I would encourage conservative sizing. Consideration of higher profile device (greater volume for a given BWD) is more common in smaller frames. However, this becomes a question of whether the volume which can be delivered in a Mod (+) device is adequate.
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 Top 100
RealSelf Hall of Fame

Hello and thank you for your question. You are a great candidate for a breast augmentation.  If you are concerned that 375cc is too large, then you could select a smaller size.  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.  Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Thank you for your question and photographs.  I think you are starting from an excellent position and should anticipate a nice result.  Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. Based on your posts I would recommend continuing to work with your surgeon to address your concerns in order to select the best implants.  Best wishes! 

To answer your question about size and how many cc’s you should get based on the size you want to achieve, first you need to take into account what's known as your base width diameter.
Imagine lying on your back and drawing a circle around your breast. If you were to draw a line across that circle, it will be a given length. Your plastic surgeon will measure this length, which is called ‘’base width diameter’’ or BWD for short. For women, the base width diameter can go from 9.5 cm to 16.5 cm, or 3.75 to 6.5 inches. As you can see, there is a very wide range. 
For example, a 300 cc implant on a woman with a BWD of 10 cm is very different than 300 cc for a woman with a BWD of 15 cm. On one it may be enough volume, and for the other it may be much less than the desired result. 
As far as the placement of the implants, placing them under your muscles - this is still the most popular technique for a variety of reasons, one of the biggest advantages is that it prevents rippling and it also hides the implant better. It is probably still recommended to replace the implants under the muscle, but a discussion of your goals during the consultation will help determine the final position.
I hope that answers your question on size. It’s great that you’re doing this research. I always say that the best patients are informed patients.
Thank you for reading and best of luck on your journey!

Thank you for your question.  I believe your measurements along with your anatomy, including your rib cage, chest width and shape of your breasts, all can play into your implant size selection.  Please remember there is also an art to this procedure and I wouldn't get too bogged down in the numbers.  Much more goes into the surgery than mere numerical calculations.  A creation of the pocket, the handling of the tissues, and your natural landmarks all go to contributing to the final result.  I would suggest you speak to the plastic surgeon you are working with to go over these concepts and allow him/her to work their magic.

Thank you for your inquiry.   Due to your small build I would recommend staying with the more narrow-based implant.   In my opinion, the moderate plus implants are too wide vs the projection.  I prefer the HP or the Natrelle SRX style implants.   You can discuss the volume with your surgeon if you would like to go smaller but the style is the most important for you.  

Based on your repeated post, it is clear that you have significant (and understandable) anxiety associated with your upcoming surgery.  My best advice: spend more time with your plastic surgeon discussing your concerns/goals, prior to the day of surgery.  Overall, given your body type and description of concerns, I think it is probable that you will be happier with smaller breast implants than what you have discussed here. Again, nothing will replace further communication when it comes to clarifying your goals, answering questions, improving planning, and relieving (some) of your anxiety prior to proceeding.Best wishes.

Thank you for this very important question. First of all I agree with you that being conservative always pays off. Second, the choice of the proper size of the implant should be based on certain measurements to be recorded on your body. We call this tissue based planning. Third, ask your doctor if he has any imaging mode that can show you your post op results such as crisalix or other available systems. They can really help you make the proper decision in chosing which size fits you better. Good luck in this process.

Hello. Thank you for your inquiry. It is important to have an in-person assessment regarding your concerns as it is difficult to determine virtually.

Exact end results and cup sizes are usually quite difficult to calculate as everyone has a different starting point.

There are many different factors that go into choosing a breast implant size which will correspond with your body dimensions while concurrently achieving your aesthetic results. Some of these factors are: Implant size (CC's), Implant profile (Low, Moderate, High), Placement of the implant (Subglandular vs. Dual Plane) etc. We utilize smooth round cohesive silicone gel 'gummy bear' implants for the best results.

During a consultation your aesthetic goals are heard and taken into account with the measurements of your breasts and the integrity of your tissue, as well as level of ptosis (sag). From here we collectively can find your 'perfect fit'. You are able to try out sizers and different implants in our office such that you can get an idea of what size you would be post-operation. We also offer Crisalix 3D plastic surgery virtual simulator during our in-person and virtual consultations to preview potential results. After your consultation, you will receive your very own implant sizers to take home with you (at a small cost) whether or not you decide to go forward with your procedure.

I usually recommend that my patients stop smoking, take vitamin C daily, and avoid aspirin/ibuprofen and vitamin E 3 weeks prior to surgery. I specialize in the 24-hour Recovery method which minimizes trauma to the breast and decreases pain post-operatively.

We encourage you to look at our website and Instagram (drkaraplasticsurgery) for lots of before and after pictures!
Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.

During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery.

We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!

M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind