What is the best size, shape and profile for me? (Photo)

I am 35 years old, 4"11 and 95lbs. I been wanting to get a breast argumentation since my breast had lost its elasticity and fullness from having my children and breast feeding had made them saggy. I had two consultation the past month and I'm still undecisive of what size since both Dr had gave me two different sizes. Please help make this less stressful. I have attached a pic of the measurement that was done. Hope that helps. Thank you!!

Doctor Answers 12

Breast implant selection based on chest measurements

Based on a chest base width of roughly 13 cm, a 280 cc range implant in moderate profile for smooth, round silicone implants would be a good fit for you.

What is the best size and shape for me

Dear Mama:

The size of the implant we choose needs to fit within the width of you chest with some consideration given to the amount of cleavage you desire. The projection from the chest wall will determine cup size but is derived by the height of the implant plus the elevation the surface from the base. Your skin tension is assessed to determine the capacity of the breast. When this is completed we can then tell you what implant will be an ideal volume correction and then if you wish to go bigger it will also tell us how much we have to lower the inframammary fold and the incision.Usually the bigger the implant the lower the incision is placed to best shape the breast afterwards. Nipple angle is also taken into account here. If the upper pole is deflated as yours is we could lift the slope gently with a textured anatomical implant best. You are sufficiently upright enough to go with a smooth round implant as well though. The choice is yours and as a rule the round implants look less natural in a female who has had children. Hope this helps.

Ken Dolynchuk, MD
Manitoba Plastic Surgeon

What is the best size, shape and profile for me?

You look like a good candidate for achieving a good result from breast augmentation, but there is no one size that is best for you. Some patients want a very conservative augmentation, some want an extreme augmentation, and most want something in between. Some patients want a very natural appearance with very mild upper pole fullness, some patients want a very obvious implanted look with significant upper pole fullness. Some plastic surgeons will take your measurements and tell you that there is one size of implant that is right for you, but this does not take any of the above differences in patient preference into account. Although you do no want an implant that is too wide for your breast or way too narrow, in fact there is some range of widths that will fit well into your breast. And, according to your tissue elasticity and skin tightness, as you go up in size there is a point where your upper pole fullness starts to become rather extreme. So, we have our patients try on sizers in a bra to get an idea what volume they would like to add to their breasts, bring in photos so we get a feeling for how much upper pole fullness they desire, and at surgery we try sterile sizers in the pocket and sit the patient up and see if the chosen size gives the desired result. If too tight and bulgy, the patient has given us permission to go down in size. 

What is the best size, shape and profile for me?

Computerized measurement can help determine a general size range for breast augmentation, but the final determination really needs to be made by you and your surgeon.  Once your doctor has examined you and assessed your desires and breast/tissue elasticity, he/she will be able to pick a size and shape of implant which will suit you well.  Also, ask if you can try the implants on in a bra.  This will not only help you decide how they will look, but also how heavy they might feel.  Best wishes, Dr. Lepore. 

Vincent D. Lepore, MD
San Jose Plastic Surgeon
4.9 out of 5 stars 50 reviews

Breast augmentation

Hello and thank you for your question. You are a great candidate for a breast augmentation.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  This entire surgery can be performed with a small incision technique.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 80 reviews

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

Silicone will give you a fullness at the top (upper pole fullness).

Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.

These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

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

#RealSelf100Surgeon

#RealSelfCORESurgeon

What is the best size, shape and profile for me?

The best cosmetic result in any particular breast augmentation patient
depends on a variety of factors, including: Your individual anatomy, realistic
expectations, a thorough discussion with the plastic surgeon about the options,
and an understanding of the pros and cons of any particular implant choice.
Proper sizing is not just about the number of cc’s. or the type of implant. The
thickness of your tissue, breast dimensions which include the width, height,
and projection, as well as chest wall width all need to be considered when
choosing an implant. Trying on implant “sizers” of various shapes and volumes
while wearing a tight t-shirt, bra, or bathing suit at a preoperative visit
will help you and your surgeon choose the optimal implant.

Keep in mind that following the advice from a surgeon on this or any
other website who proposes to tell you exactly what to do without examining you,
physically feeling the tissue, assessing your desired outcome, taking a full
medical history, and discussing the pros and cons of each operative procedure
would not be in your best interest. I would suggest that your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the
American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are
comfortable with. You should discuss your concerns with that surgeon in person.


Robert Singer, MD FACS


La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

What is the best size, shape and profile for me?

This is the most common question we get and is unanswerable. Picking the right implant requires a consultation first to determine your goal look. You should have already shown photos to your surgeon of the look you want. Then it requires an exam to determine the rib shape, breast and chest dimensions and quality and amount and shape of the existing breast tissue. After all that is accomplished we can make reasonable recommendations for a specific patient. Your surgeon has done all that, now it is time to either trust the doctor or see another one. Good luck.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Breast Implants

Hi Mama,

This is always a hard one.  You are not alone.  It is good to get lots of opinions.  Nice work.  You are 95 lbs.  and have some extra skin from your kids.

Here are a few tips for you because this is perhaps the hardest decision for a patient to make, as well as the surgeon.  Also see the video attached to my answer.  We spend up to two hours for our BA consults to be sure there is careful communication. We do a full exam in front of a full-length mirror taking six exact measurements.    We put your photos on a large computer screen for imaging, and go over your “ideal-size” photos. We then save this information to your password protected “web account.”

     First and foremost the implant should fit the dimensions of your breast and tissue cover.  Balancing the implant to your over-all body shape and tissue cover is essential.    The main thing is to have the diameter of the implant fit the diameter of your breast "foot-print".  Higher profile implants tend to have a smaller diameter.  Higher is really a marketing term, but often translates into the same volume implant with a narrower base.  Saline implants actually tend to decrease in diameter as they are inflated!  The average size chosen over our last 7,000 breast implants was “350cc”.  BUT, 90% of our patients tell us they wish they were bigger a year after BA.  (We will see you every year for routine checks at no charge.) It’s like your mind incorporates the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients that they will experience an increase of approximately one cup size per 200 cc.  You can try on implants in the office by placing them into a special bra.  The implant is also flattened somewhat when under the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for flattening of the implant in the partial sub-muscular pocket.  Once you decide on a size you like, then add on 25cc, because in real life the implant will be flattened slightly by your tissues.  Multiple measurements need to be taken to fit an implant to your exact anatomy.  Have your surgeon's office show you the charts of the implant dimensions for the various profiles of silicone and saline from the manufacturer.  Then you and your surgeon can piece together the puzzle by matching your measurements, with your wishes, versus your tissue cover and the available implants to arrive at a surgical plan.  Keep in mind larger implants tend to have more problems over the years.  Since silicone implants wrinkle less than saline implants, they might be your best bet.

     You can also approximate this at home by measuring out an equivalent amount of rice placed into a cutoff foot of old panty-hose, and put this in your bra.  Wear this around the house for a while, and see what you think.  Implant size must square with assessments of tissue cover, breast diameter, and chest wall width.  Multiple measurements of your chest wall are taken (seven in total).  Implant size selection has been an issue of much discussion.

     Therefore, I use a wide variety of methods, but the implant size is always established preoperatively.  Also, patients are advised to bring reference photos demonstrating their ideal size and shape.  A photo album of patient pictures is maintained to assist them.  These photos ultimately help in determining where the implants will be placed, since they can be shifted inside (to provide more cleavage), to the outside, up or superiorly, and down or inferiorly during surgery.  In determining the final size selection, I always place the highest priority on the preoperative measurements and potential tissue cover.  Finally, your verbal requests are factored into the analysis.

     We use the quick-recovery approach, so click on the web reference link below to have this explained and you can see the list of Quick-Recovery (Flash-Recovery or Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery journals.  It is a surgical procedure that uses special instruments and techniques to minimize tissue damage and avoid touching the ribs. It causes far less trauma to surrounding tissue than traditional approaches, and it dramatically reduces pain and recovery time. In published studies of BA patients, 95-percent of women interviewed after the procedure returned to normal daily activities within 24-hours. Quick-recovery BA is not a “gimmick.”  These specialized techniques, which actually speed recovery and get you back to your daily routine, kids and work, are published in our plastic surgery journals.  Because these PS journals are “peer-reviewed” and edited, they are the gold-standard in our field as being valid science. Therefore, these are sound techniques, not marketing hype. 

     Be sure to see only a board certified plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member of ASPS (The American Society of Plastic Surgeons).  Also, ask if the PS has an established, high volume breast augmentation practice, performing several hundred breast augmentations each year.  Be sure the PS has been in practice for a while, about 20-years might be a good gauge.  Does the PS offer all three incisions?  Discuss the implant type (gel or saline), shaped "gummy bear" or non-shaped, smooth or textured, implant pocket (over or under the muscle) and the "quick-recovery approach."  Ask to see their before and after photos if you didn’t see any on their website.  If they are experienced, they should have several 100 breast implant patients for you to view.  I would also recommend that your doctor offer you the chance to talk to past patients who would be happy to discuss their experience with you.  You need to feel comfortable, so make sure the environment is safe as in an accredited surgery center.  Also, ask a prospective surgeon if he or she has ever published journal articles in professional peer-reviewed journals, which they can provide you.      

All the best, “Dr. Joe”

 

 

Choosing size, shape and profile of breast implants

Hello, for the majority of my patients with normally-shaped, moderately-sized breasts like yours I insert round silicone gel implants.  The sizing must be done during a consultation because it involves not only assessing the person's anatomy but also looking at their wish pictures, 3D Vectra breast imaging, and trying on sizers.

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.