Breast implant sizing - Is it ok to go one cm more than my breast width?

Question

Is it ok to go one cm more than my breast width? My breast are 10 cm and 10.5 cm. I’m almost flat chested. The size I’m considering is a low profile (natural look) 340 cc And 360 cc to correct asymmetry. If i go 1 cm more than my bwd is it ok? I don’t mind a little side boob for a curvier look.

Robert M. Lowen, MD · Answer

Dear mrs.401,
   There is a little wiggle room with width as a guide, since there is not an absolutely definite breast width.  It depends somewhat on what point is being chosen to measure from.  However, there is a maximum based on the widest sizing points.  With little breast tissue as a guide, and taking into account that a small or very small breast is intended to be made larger in all directions,  the anatomic boundaries of the new breast implant footprint will relate to the point inside the pectoralis origin medially, and the lateral pectoralis boundary.  Going beyond this can cause a problem, even 1 cm, because the weak fascial attachments laterally and inferiorly can be disrupted enough to increase the chance of lateral and or inferior malposition.  So in your individual case, this question should be answered by your plastic surgeon who can precisely evaluate your breast dimensions, soft tissue coverage and how they relate to your desired size.  For women with a lot of subcutaneous fat and a larger breast to begin with, an additional 1 cm width can be acceptable.  Also, don't forget, that for a given volume, a low profile implant takes up more space; it is wider than a moderate profile.

Daniel Barrett, MD · Answer

Dear mrs.401,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Javier Parada, MD · Answer

Yes, going about 1 cm wider than your breast base width can be appropriate in selected cases&mdash;especially if you’d like a bit more side fullness for a curvier look. The key is doing it conservatively and with precise pocket control to keep the result natural and avoid the implant drifting too far laterally.Your plan of 340 cc / 360 cc to correct asymmetry sounds very reasonable, and a low or moderate profile will help maintain that soft, natural appearance you’re after.In your case, a carefully selected implant with meticulous tissue adjustment would likely give you a beautiful, balanced result with minimal visible scarring and a very natural feel.

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. Staying within a centimeter of your measured width is advisable.
-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." 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

In office evaluation needed to 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 and style 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 size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Ned Snyder, IV, MD · Answer

Thank you for submitting your questions!  Yes, you can place an implant that is 1cm wider than your natural breast width.  I would not recommend much wider as you run the risk of implants touching in the middle (over the sternum) or creating too much “side boob” that’ll get in the way of your daily activities.
Good luck and thanks again for reaching out!

Breast implant sizing - Is it ok to go one cm more than my breast width?

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