What is a Safe Range to Stay in when Matching the Diameter of a Breast Implant to Your Bwd?

When choosing a breast implant to match your bwd, how close do you have to be? Is there a range that is safe or recommended? Is going over 1 cm really going to make a big difference?

Doctor Answers 9

Matching the diameter of the implant to the breast

I generally agree with Dr. Motoki, but I subtract 3/4 to 1 cm from the measured diameter of the breast (upright with arms down) and that way I know the implant will fit in the proper place behind the breast, fill it out naturally, and not stretch or distort the tissues. It's a bit like fitting your foot in a shoe. If the foot is too big for the shoe you may be able to cram it in but how the shoe handles the excess width is unpredictable and can cause multiple problems. I am not willing to risk this just because the patient says they want it. If the tissues weren't so forgiving as in a hip implant, there would be no leeway at all. Properly sized and positioned, a breast implant should not thin, stretch, or change the surrounding tissues or skin. It doesn't matter what they are it won't change them. 

The reason that you can choose the forward volume (profile) of the implant is that as long as it fits the width, the tissues will accommodate forward volume up to a point without causing problems other than perhaps some excess upper pole bulge with high profile forward volume. This is also like a foot in a shoe (at least one that is open over the dorsum of the foot and can be adjusted with laces). 

As in many things, you might get away with asking the tissues to accommodate and implant that is too big for the place it belongs but you're asking for problems and losing control over the result. 

Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

Sizing Breast Implants

Hello Bird,

It's really a matter of degree.  In general, keeping the implant within the diameter of the bwd is considered the safest way to minimize rippling, but the truth is there are other factors that come into play including your tissue thickness beyond the breast mound (directly over your ribs, but immediately next to your breast), your measurable tissue elasticity, and the unmeasurable (and unpredictable) way your body tissues might stretch and thin due to the force of the implant.

So the answer to your question is it might make a difference, it might not.  Without a physical exam, or even a photo, it would impossible to give an educated guess.

BTW, bwd is not the be all and end all to measurements that should be made to determine implant size, volume, profile, and placement. There are a few others: tissue pinch thickness above the nipple and below the inframammary fold, anterior stretch of breast distance, and nipple to inframammary fold distance under stretch. By utilizing these five parameters, an implant can be chosen, and with proper surgical technique, your risk of complications and unplanned reoperation can be reduced by a factor of 10.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

Breast implant dimension

I never use the diameter of the implant to match your body.  What is relevant is what your goals are, where the implant is placed and whether you need a lift at the same time.  In the retro-pectoral position, high profile implants will make very little difference.  I would discuss with your plastic surgeon your desired goal.

Best of Luck,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Implant diameter and breast width

In general keeping the implant diameter within 1-2 cm of the breast width is a good idea. As you get into larger implants this is why plastic surgeons start to use high profile implants in order to get the volume without the wide base. If you are looking at a large implant then slightly over your base width might be required for that volume. At 1 cm you should be fine but in all honesty I would let your plastic surgeon focus more on what profile implant to pick and focus more on the cc volume you want. It's less confusing and like others have mentioned implant sizing is a bit more complicated than just bwd. Hope that helps, Dr Kerr

Mahlon Kerr, MD, FACS
Austin Plastic Surgeon
4.9 out of 5 stars 216 reviews

Chosing your breast implant size

The biggest mistake I see women make when selecting the ir breast implant is arriving at a decision without the input of their plastic surgeon. Implant width relative to breast width is an important variable, but only one of many. Take full advantage of your surgeon's experience in order to best meet your goals.

Mary Lee Peters, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 114 reviews

Breast Implants: How Big Should You Go?

As a general rule the width of the breast implant should be 1 to 2 cm smaller than your breast width. Placing an implant with a larger width could result in an unnatural look with the implants extending beyond the lateral chest into the underarm area. This can also inhibit normal arm movement. Larger breast implants could result in soft tissue thinning where it is easier to feel or see the edge of the implants. This can be difficult to correct. See a surgeon certified by the American Board of Plastic Surgery and get more than one opinion.

David S. Motoki, MD
Draper Plastic Surgeon
5.0 out of 5 stars 16 reviews

Breast base diameter is only one factor in implant selection

The breast base diameter is only one factor, and possibly the last, to figure an appropriate implant size. If the implant is too narrow for the breast or chest we can have a gap between, or if too large the implant may run out the side of the chest, or the implant can be bunched in and prone to ripple or fold. You may go over 2 cm without porblems, or under by 2 without a big impact on aesthetics.

Best of luck, Peter Johnson, MD

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Base width and implants

I think that the base width of the breast is a guide for your choosing an implant. I like to stay within a cm or two of the base width and this also depends upon the elasticity of the tissues.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Breast Implant Diameter and Breast Measurements?

 Thank you for the question.

Unfortunately,  choosing breast implants to best meet a patient's goals while maintaining safety,  cannot be boiled down to a simple “matching diameter of a breast implant to your breasts with measurement”. There are many variables involved...

I would suggest that you consult with well experienced board-certified plastic surgeons and allow him/her to use their experience/judgment to guide you.  Communicate your goals clearly ( I prefer the use of gold pictures);  this communication will be key for you and your plastic surgeon to work together in achieving your goals.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.