Selecting the right implant.
"What implant is best for me?" is a great question. It is also one of the most frequently asked questions and probably the most important question to answer in order to achieve the best outcome for each individual patient. Each surgeon will have his or her own personal criteria for implant selection. In my opinion it is very important to begin the selection process by carefully listening to the patient's goals and concerns relating to breast enlargement. I find that the great majority of patients want to be made as full as posssible without looking artificial. This means an outcome with some, but not excessive, fullness in the upper part of the breast. Many patients will state the cup size they would like to achieve. Although cup size varies from one vendor to the next it helps to begin to understand the general size the patient wants to be and to determine initially, if the goals are realistic. Many patients bring pictures of breast implant outcomes they would like to achieve. Although the final outcome for each patient will be dependent on their preoperative shape and size photographs are helpful to have a general idea as to the outcome desired by the patient. External sizing implants are also helpful in determining a final breast volume. These are specially made, form fitting implants that are placed into a snug fitting sports bra. A suitable top is then put on. The patient can look in a mirror and provide their opinion of how they look. Many surgeons utilize 3-D imaging. This is new technology that creates a reasonable 3-dimensional picture of how a patient will look after breast augmentation. After a general idea is acheived chest wall measurements are taken to help refine the selection. Smooth walled silicone filled implant are nomally a good choice for breast augmentation.They have a better look and feel and are less likely to show wrinkling. These implant differences are more apparent in patients with less breast tissue to cover the implant. This series of steps usually leads to the preoperative selection of the best implant. One final step can be taken to confirm the selection. After the pocket is created in the operating room an intraoperatve sizing implant can be temporarily placed in the pocket. The back of the operating table can then be elevated so that the surgeon can view the patient both laying down and in the sitting position.Occasionally this final refining step will result in a slight change in the preoperative selection and help ensure the best outcome for the patient.
My patients find it helpful to try on implant sizers with a form fitting T-Shirt in the office in order to get an idea of how they will look. Your Plastic Surgeon can likely provide you with a few, similar sized options to try. All the best
Hello and thank you for your question. The size 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. 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. The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
There is no way to give you an accurate recommendation based on an internet evaluation. I strongly recommend that you not rely on internet information for this process. Talk to your surgeon on a consultation. If you aren't sure, go for a second opinion. Implant size is based on patient size. That is much more than you have provided. (I think the only thing you have provided may be your base diameter, but I can't even be sure of that.)The internet is a great thing. It gives you ready access to all kinds of information, and it certainly is a great source of entertainment as well. However, it can also be damaging. Last week I had a patient come in having already picked out the exact treatment they wanted. Sounds great, right? Well, what they had picked out wouldn't have really done much. So are they signed up for the right treatment? No. They were so convinced of what they read on the internet that they believed that over the actual doctor--even though the better treatment was also cheaper. Now they are no better off than before but with a lighter wallet. Do not be like that person. Get your consultation. Show pictures of what you'd like to see as an end result. Talk to your doctor about the pluses and minuses of that treatment specifically for you. Make your decision, move forward, and follow your doctor's advice.Good luck.
Thanks for your question regarding breast implant choice. Typically, the size and type of implant is based upon your chest wall measurements as well as your post-operative goals regarding how you will look in clothes vs. bra. Work with a board certified plastic surgeon who uses 3D imaging to help you see how you might look after surgery. Wishing you all the best,Steven Camp MD#HappyCamperMD
Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision
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!
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
Breast implant silicone moderate. Any suggestions?
Thank you for the question.
Online consultants will not be able to provide you with specific enough advice to be truly helpful. 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, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
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 with 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 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 concerns) helps. Best wishes for an outcome that you will be very pleased with.