Proper Breast Implant Size for Thin Woman?

Hi there-One of the things I find most interesting is the amount of misinformation the average patient must sift through when researching breast augmentation surgery. In particular, I think that many patients become overwhelmed with implant choices and the abundance of information about these options available on the Web.This is complicated once they contact a surgeon or two for information about the implants, and which is most likely to give them the result they desire. Somewhere along the way, opinions expressed by a surgeon are perceived as fact by a prospective patient (because of the surgeon's reputation or the apparent strength of his/her opinion), who then becomes more confused when she hears a differing opinion.This leads to ridiculously technical questions being posted on sites like RealSelf and others, such as:"I am 5'5", 125 lbs, my measurements are 34, 22, 36. I have had 3 babies, all by C-section, and I breast fed two of them. My breasts sag a little, but not as much as some women I have seen. I want to have a full C-cup breast. Should I get 325 cc Allergan 410 style implants, or Mentor 350 cc Moderate profile implants. Projection is more important to me than a natural shape..."Every time I get one of these over-thought questions, I always think the same thing... ???????Let's take a big step back from the trees here and take a look at the forrest in front of us, shall we?Fundamentally, the reason any woman seeks breast augmentation is because she wants to achieve a certain appearance, right? Let's repeat that- to achieve a certain appearance. NOT a certain bra size, or a certain implant volume, or even a certain implant type. When you first stared to think you might want an augmentation, you didn't think, "I would like it if I could have 350cc implants"... You probably thought, "I would love to look like that (after admiring another woman's breasts)..."So if we can agree that what you are really after is an appearance you would be happier with (as I always tell my patients), let's make the desired appearance the focus of our communications...Let us both ignore bra sizes (which are not standardized and the choice of which is very arbitrary) and implant types/sizes (for now)... Let's first understand what you want to look like. I think you would agree that if we are able to make you look the way you wanted to look, the letter on your bra and the number on your implant is lees important, right? Help me understand what you want to look like, and I can give you a very accurate recommendation of options for achieving that appearance -- provided a careful physical examination has also occurred.Why is the exam so critical? After all, can't we just put small implants in women who want small breasts and larger implants into those who want larger ones?The exam is critical, because for any one particular woman, there are only a few good choices of implants available, regardless of her goals, and these options are arrived at by taking careful stock of her breast tissue, skin, and frame. In other words, your anatomy will, to a large extent, help us understand the implant options that would make you look the best. This is the "One Right Result" concept. The taking of these measurements is so important, I do it myself every time, and based on these measurements and my patient's goals, then make recommendations regarding the implant options available to her (as these options would be different for different women).While (as with any aesthetic procedure) no guarantee of outcome can be given, you are much more likely to achieve your desired outcome if you focus on communicating your desired appearance successfully with a skilled and experienced, Board Certified Plastic Surgeon than by over-researching the implants and micro-managing the details of the surgery. In fact, I can think of no better way for you to increase the odds of you ending up dissatisfied.So don't over-think it. Think carefully about the appearance you want, communicate it carefully to your surgeon (using photos if possible), and make sure that the implant choice arrived at by the two of you together is based on both your anatomy and your goal. You'll be happier and the process will be less stressful!

THe most important determination is the width of your chest wall.   Selecting an implat that will fill your ideal 'breast footprint' is essential.   Secondly I would strongly recommend a subfascial technique to avoid strange looking results of submuscular or dual-plane augmentations in thin women.  Using subfascial placement creates a more natural tear-drop form and softens the edges of the implant.  I use a COLD-SUBFASCIAL technique to insure that the full power of the fascia to shape and support a natural looking breast is attained.  Also avoid high profile implants.  These are generally too narrow for women like you.  I prefer a wide implant with projection being created by the fascial dissection.  I hope this helps!

 

 

All the best,

 

Rian A. Maercks M.D.

Size is a complex decision that is not only based upon your height, weight and current cup/bra size but ALSO on also on your breast diameter, waist, shoulder, and skin envelope measurements. These can only be assessed in person during a consultation.

Pinkestarr,
The size of your implants depends on a couple of things. First, the width of your chest and the width of each breast. Secondly, the distance from the bottom of your areola to the crease is an important measurement. These measurements help the surgeon pick the appropriate size implant for your frame. Now you can demand that regardless of those measurements and other measurements that larger implants are placed. The problem with this is that the result is not as natural and that the weight of a larger/heavier implant will over time stretch your skin.
The best way to determine which implant size, type (silicone vs saline), position (under or over the muscle) and incision type is best for you would be to have a consultation with a board certified plastic surgeon.
Best of Luck.
ES

It is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" 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.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the press implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.

I consider two factors when selecting implants for my patients:1.Dimensional planning2.Gel Implant Sizing systemDimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. Even your fitness levels and other relevant criteria are taken into consideration. It is you who will decide what you are comfortable with.Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for.This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.

Without examining you, it would be difficult to say how big you should go with implants. Remember the larger you go the more risks of sagging and the less natural.

Choosing the correct size implant is one of the biggest fears that my patients have.
The other doctors' answers talk about the factors that the surgeon uses to evaluate your chest. How wide is the breast? We do not want to use implants that are too wide and fall into the arm pit. How loose is the skin? There must be enough stretch and laxity to accommodate the implant. How much breast tissue and fat does the patient have? Saline implants placed under thin skin can show folds and wrinkles in the implant.
You are asking " How does the surgeon read my mind an know what size I want?"
Most surgeons have before and after pictures or fill bras with trial implants to help figure out what their patients want. For almost a year, we have been using the Portrait 3D computer simulation to help our patients visualize and actually see what the implant will look like on their own chest.
This system takes a computerized 3D image of the patients chest. We use the traditional methods to determine a starting point. The computer "performs " the surgery and inserts the implant into the image on the screen. Now we can go smaller or larger and truly read our patient's mind.
A recent study showed that 90% of patients felt that the Portrait 3D helped them choose the right size implant.