Breast Width is not the Only Measurement
Hello,Like so many women, you are under the impression that finding an implant that fits between your breast width is the only thing that matters, but I assure you it isn't. There are other measurements that are just as important to determining implant capacity. UHP implants are shaped like balls and put greater pressure on your tissues, which leads to stretching, thinning, malposition, and rippling. You need to except that you may not be able to fit an implant that would otherwise meet your aesthetic goals. It's really just like shoes. You wouldn't buy a pair if they didn't come in your size, would you?Best of luck!
Petite patient and breast augmentation surgery concerns…
Thank you for the question. 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, and computer imaging) will be critical.
I have found the use of "higher profile" breast implants very helpful when it comes to achieving very nice outcomes for patients with small frames. Many of these patients, despite their very small frames, do wish to achieve a relatively full look (relatively large volume for their small frames). In these cases, a well executed procedure and selection of appropriate breast implant size/profile is not necessarily associated with more "negative outcomes" than the use of lower breast implants.
On the other hand, every patient undergoing breast augmentation surgery should understand that their anatomic starting point will limit the outcome of breast augmentation surgery. In other words, a patient's starting anatomy will limit how large of a breast implant can be utilized safely. The use of a larger breast implant(than what is safely "allowed" by the patient's anatomy) can be problematic; potential problems include breast implant displacement/malpostion issues ( such as bottoming out, lateral displacement, symmastia...) and/or significant breast implant rippling/palpability.
***Given your concerns, I would suggest that you schedule additional time to spend with your plastic surgeon communicating your goals, 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 we have time for a you their stuff's's homewith 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, dedicated to breast augmentation surgery for petite patients) helps. Best wishes for an outcome that you will be very pleased with.
The higher the projection the more spherical rather than disk shaped the implant. Your implant profile is best selected taking into consideration the volume increase that you are hoping for and the base width of your current breast that serves as the platform. If an xtra full projection is deemed best it is because you are hoping to stuff in a lot of volume in a small space. If your tissue needs to do a lot of stretching to accommodate this much volume stuffed into a small space the results can be less predictable. There will be more of an artificial look if the projection is exagerated which may be fine for some, but not what many patients are hoping for.Good luck
With your anatomy, the correct implant choice and the right surgeon you can achieve your specific goals
The most sophisticated approach to breast augmentation is through the armpit with a surgical camera (transaxillary endoscopic). Using this modern approach the space can be crafted under direct vision, with virtually no bleeding and no postoperative bruising. Most importantly, the shape of the breast is meticulously created. The other, older methods of insertion are technologically less advanced. Both silicone and saline implants can be placed through the armpit by a surgeon with skill and experience using this approach. The incision in the crease is the oldest method of placing the implants and puts a scar directly on the breast.
A round implant would be a better choice because they move more like breasts. The anatomic implants have a textured surface which makes them feel very unnatural. In addition, there is no benefit to anatomical. There is an X-Ray study that shows the implants from the side at 6 months. Standing, the round and the antomical implants have the same profile. When you lie down however, the anatomical implants do not change, which is unnatural. A round implant will change when you lie down, like a natural breast would.
HP implants, which are a more modern shape than moderate profile implants, fit most women better. They have a more appropriate base diameter and can be made to look very natural or very augmented, depending on where in the range the implants are filled to achieve a particular volume. High profile implants are the first choice in my opinion. I rarely find an indication to use moderate or moderate plus implants. The subtlety in the final outcome is not achieved by which profile implant is used, it is determined by the skill in the creation of the pocket, the choice of volume, and where in the range the implant is filled.
There are many advantages to sub muscular dual plane placement and very many disadvantages to sub glandular placement. I would see no indication to do anything but sub muscular dual plane. Subglandular silicone implant placement is the historical approach to this surgery, and was widely used in the 1960's. The implant edges are more visible, the risk of rippling is higher, the implant is in contact with the non-sterile breast tissue so the risk of infection and capsular contracture is higher. The interface between the breast tissue and the muscle is blurred so the implant interferes with mammography more than sub muscular placement. The blood supply surrounding the implant is worse so the risk of capsular contracture is higher. The support for the implant is less so there is more long term shape abnormalities and sagging. The look of a sub glandular implant is much less appealing than a sub muscular implant. The placement of sub glandular implants makes any subsequent revision surgeries more complicated and less successful. There are no advantages to sub glandular implant placement.
The choice between saline and silicone is one that requires a complex discussion of all of the advantages and disadvantages of both implants. The issues to be considered are safety, density, mobility, rippling, rupture rate, consequences of rupture, detection of rupture, need for follow-up care, cost of follow-up, appearance, feel, sensation of heaviness, radio-density, mammograms, and costs, among other things. There are advantages and disadvantages of both products. The decision will ultimately be up to you based on what is appropriate for your particular situation. Beautiful results can be obtained with either implant.
The best way to determine the size that fits your personal perception of the perfect breast is to try on sizers. This way you can see how they fit on you, how they add to your current volume, and whether they fit your frame. Although the surgeon can guide you, only you will be able to tell what is the right size. Try on sizers. Measuring a diameter and then telling the patient what volume they can have (in high, moderate or moderate plus implants) in my mind is backwards. The patients should be allowed to choose the volume. Then the surgeon carefully considers the base diameter, projection, profile, manufacturer, and fill material that will achieve the patients goals of size as well as qualitative look (natural, intermediate, or bold upper pole fullness or projection), all the while taking into consideration the patient's anatomic features that will affect the outcome. The experience of the surgeon and the degree to which they explain the options to you is of utmost importance. The subtlety in the final outcome is not achieved by which profile implant is used, it is determined by the skill in the creation of the pocket, the choice of implant. Don't let the doctor tell you what would look good on you. They cannot tell what you perceive to be the best size. There is no maximum. That is up to you.
All implants have certain risks, and of course benefits. Perhaps a larger implant has slightly larger chances of malposition, etc, but if that is what you want to get you the look you desire so be it.In my experience I do not feel like I really see more issues from larger implants.From your previous "wish boobs" I wonder if the SRF is a lite bit much for you...have you used the Vectra?Best of luck!
The projection of the implant is determined by the volume of the implant in a given width. In order to get a high volume but keep the implant narrow, you have to have higher projecting implants. Otherwise, the implant would be too wide for your body.