14 to 15 cm bwd, what to do?

Question

I was measured up to be 14cm to the right breast and 15cm to the left breast with a ptosis that my ps has suggested as mastopexy. I am finding that it is quite large in regards to cc's. I want fullness to the top of my breast, but dont want to be huge and sagging in a few years to cause extra stretching in my lifted breasts. Can I chose a size that measures smaller at the base than what I measure at or will that look funny? Suggestions ?

Austin Hayes, MD · Answer

So this is a really good question. It's a little difficult to answer without photos, but I'll do my best to explain the decision-making process.First let me complement you on your judicious approach to your surgery. Your 100% right that it's important to not select an implant that is too large, because it will stretch out your breast more quickly. Your breast tissue has already been stretched. It's important to make your results long-lasting.When sizing an implant, you typically select an implant that is 1 cm smaller, or up to 0.5 cm larger, than your breast base diameter. Of course you can vary this somewhat. Don't forget about implant profile. During a lift/augmentation, it's common to use a low or moderate profile implant, not a moderate plus or high implant. If you have enough breast tissue already, and just need a little extra volume to fill out the upper pole, then it's reasonable to use a lower profile implant. A lower profile implant has a larger base diameter for the given volume. It will allow you to choose an implant that fits within your breast base width, but have a lower overall CC (volume). Discuss these options with your surgeon. There is also an option to use additional materials to create an internal bra that further helps support the implant. This increases the cost, but helps support the implant so that your skin doesn't have to hold all of the implant weight.Congratulations on your upcoming surgery.

Ted Eisenberg, DO, FACOS, FAACS · Answer

It's always a good idea to have an open, frank discussion with your plastic surgeon about your goals. That way you can best achieve your desired result. I show my patients before and after pictures of women, similar to them in height, weight, frame, and starting volume, who got implants of different sizes. This assists them in  determining what size implant to get. To read more about simultaneous augmentation and lift, click on the link below. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths."

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The best way to determine implant size is based on chest wall measurements that fit your body.  Once we determine that we can choose the profile based on what you want or need to achieve.

Implants under the muscle, there is less risk of capsular contracture.  Anatomic implants tend to give a more natural shape with more nipple projection.

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

Board Certified Plastic Surgeon

Director-Beverly Hills Breast and Body Institute

#RealSelf100Surgeon

#RealSelfCORESurgeon

Tom J. Pousti, MD · Answer

Thank you for the question.  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.

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 know words such as “natural” or "C or D  cup” or "huge" 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.

14 to 15 cm bwd, what to do?

Answers (4)

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