BWD - 10.5. How much does your BWD truly limit you?

Question

I am looking to get a breast augmentation, and have had two consultations. 1 surgeon said I can not go higher than a 275 full profile Motiva, the other said a 320 demi profile would be the max. My breast width diameter is 10.5, and per the motiva chart that would be 230 in the demi profile, and 275 in the full. I definitely want demi profile ergonomix, but a 230cc will not give me the results I am looking for. Is going to 320 demi profile safe even though the BWD for that size should be 11.75cm?

Donovan Rosas, MD · Answer

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." 
With regards to your specific question, respecting the BWD is important but small variations are unlikely to have significant impact. Exceeding BWD is not a question of safety but rather shape with overly wide devices contributing to a mismatch between implant and frame. 
Communication is key as you and your surgeon create your custom surgical plan. 
As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Ted Eisenberg, DO, FACOS, FAACS · Answer

Choosing the right size and profile breast implants for you. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  I have been in practice for over 30 years and breast surgery and revision breast surgery is a large portion of my practice.  I truly believe that the emphasis on breast width is way overly done.  There should not be much of a limit to how large of an implant that you can place.  You should easily be able to get in the high 300s or low 400s.  Do not let an experienced surgeon tell you otherwise.  Best wishes to you.

BWD - 10.5. How much does your BWD truly limit you?

Answers (3)

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