Implant width bigger than breast? (photos)

Question

The width of my breast is 12.8. The implant I like has a width of 13.2cm with a 4.6cm projection (435cc) The one below that is 12.5 cm in width, 4.5 cm projection (385cc). The implants are Sientra Smooth Rnd Mod+ . I have read on this site that the implant should always be smaller than the breast. There doesn't seem to be that big of a difference between the sizes. Should I call and ask for one size down or will the original implant I picked be ok.Don't want cleavage to touch. Or be to wide .

Donald Groves, MD · Answer

Hello and thank you for your question. Honestly, a formal in-person evaluation would be needed to determine the best treatment. There are several reasons for this: 
1) Bra sizes vary based on the clothing store (for example, Victoria's Secret tends to upsize everyone by a whole cup size)
2) Most women do not wear the proper exact fitting bra size for their bodies
3) The exact volume (in cc) needed to change cup size is different for different body types (e.g. 32A to 32D requires a different implant size than 38A to 38D)
4) Be careful NOT to fall into the trap most women do- they see a certain implant size (e.g. 285 cc) or perhaps their friend had a certain size, and they want or request this or another size based on that. Everyone's body is different- 285 cc implants on your friend might look VERY different than they would on you. Be very careful not to make this mistake, because the goal is to find the right size and shape for YOU- for your particular body and your breasts.

Because of those multiple factors, and because it is KEY to fully evaluate your breasts in person to make a full set of precise measurements to select the proper implant for you (incorporating factors like amount of breast tissue, implant type, base width, projection, etc), answering your question really would need a formal personalized consultation- to say anything before that would simply be guessing, which would be both unfair and unhelpful to you. Also, just FYI, each surgeon's measurements are slightly different, so numbers, experience, and overall aesthetic from one surgeon aren't necessarily the same as those from another surgeon!

Your breasts are such a KEY area of your body and your femininity- therefore, you should ONLY trust an experienced aesthetic plastic surgeon. As such an expert, I have had extensive training and experience with complex aesthetic surgeries under a multiple world-renowned experts in the field. I’d recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with aesthetic plastic surgery procedures) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Ira H. Rex III, MD · Answer

In general, plastic surgeons often use breast width and implant width just as general guidance to choosing the appropriate implant for the patient. It is not unusual to have a wider implant than breast base width. Much of this depends on the look you are seeking. Also, it is guided by how much breast tissue and fatty tissue you have at the outer zone of your breasts. It seems best that you read assess all of this with your plastic surgeon so you are both on board with achieving your expected results.

Thomas Fiala, MD, FACS, FRCSC · Answer

Hi.  It is unwise to pick an implant wider than your base width.  This could give extra side fullness - making you look heavier, and is more likely to lead to lateral pocket expansion or lateral rippling and a need for re-operation, particularly in someone slender like you.

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

Richard Baxter, MD · Answer

If the implant is wider than the breast, then the pocket has to go beyond the anatomic boundaries of the breast. This can lead to thinning of the tissue envelope which in turn increases the risk of visible rippling and implant bottoming out. These are particularly important issues for a thin person like you. There are several different implant profiles so that the size can be increased by projection or diameter.

Dan Mills, MD · Answer

I like to tell my patients who are considering breast augmentation that the breast is a PYRAMID. You start with the base and build up. The base width of your breast gives your surgeon a starting point and helps narrow the choices. Depending on your desired look, the profile is then agreed upon. In my practice, I prefer implants that are at least the width of your natural breast if not a bit wider -- again using the PYRAMID analogy. In order for the breast to appear natural, the implant sitting either under the gland or under the muscle should be the widest part of the breast. Of course one must take care to avoid over  dissecting the pocket which could lead to symmastia (uni-boob) or an implant that's too far into the armpit. For those who want more cleavage, I generally recommend a low profile implant because I want a wider base implant that will give more fullness between the breasts. For those who want more projection, I choose a moderate or moderate plus implant. For those who like the shelf bra look, I go high. Remember though, that everyone's chest wall has it's quirks and posture influences how your breast will look. You should make sure your surgeon evaluates you thoroughly. I have partnered with Sientra since they first came out and use them in the majority of my breast augmentations. They provide implants only to board-certified plastic surgeons so patients know they are getting the best. I hope this helps! -Dr. Mills.

Tom J. Pousti, MD · Answer

Thank you for the question.  Based on your photographs, I think that you are starting a good place and should have a very nice outcome with breast augmentation surgery. There are no hard and fast rules when it comes to diameter of breast implant versus diameter of breast (band width). In other words, these measurements are useful but are only one of the many factors come into play when it comes to selection of appropriate breast implant size/profile.  You are correct in that over dissection of the breast implant pocket and/or selection of a breast implant that is to large for a patient's frame can be problematic, including greater risk of implant displacement (symmastia, bottoming out…) concerns.

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.

***Given that your surgery is coming up soon, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.

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

Implant width bigger than breast? (photos)

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