Ultra High Profile? 120lbs, 5'7'' BWD is 11cm. 32A wanting to be in the D range. PA is thinking 460cc UHP.

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

Thank you for your question. Based on your photos, you appear to have a nice starting place and should have a nice result with breast augmentation surgery. The most important factor when sizing implants, is working closely with your surgeon in person to find the implant size that gives you the look that you desire. Careful measurements of your breast and chest wall will help determine which size implants will fit within your natural breast footprint. Taking into account your desired look, and your measurements, an implant is chosen that specifically fits your body. Unfortunately, online recommendations are not that helpful.  In general, ultra high-profile implants will have a more round appearance, particularly in women with less breast tissue to camouflage the implant. 

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.   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

This is always the major question. The best way to answer, in my opinion, is to actually try on sizes at your surgeon's office. A lot also depends on your skin laxity and, therefore, the capacity of your breast tissue to 'handle' the implant volume. Based on your pictures, you do have a little 'slant' to your chest, meaning that any projection from your chest will project slightly more to the side than straight out. With that anatomy, the larger the implant, and the more projection, will actually make you look farther apart, like you have a larger sternal gap than you actually have. UHP implants, by design, have more projection, and therefore, would accentuate that gap even more so. You also appear to have a rather low-set breast, and, imo, will appear very low, with large implants. In your case, I might suggest, if verified with an in-person exam, a shaped implant to fill the upper pole of your breast and get a more subtle transition from the chest wall to the projected part of the breast. I think you will get a nicer shape, and a more natural result. Trying to achieve a cup size alone, I believe, is the wrong approach. Bras are not universal in their cup size measurements and cup sizes vary tremendously from store to store. You are going for a look, not a cup size. No one taps you on your shoulder and says: "Hey, you look great! What cup size are you?" So, throw the cup size desire out the door, try on sizes without mention of the volume, and look in the mirror. Also, if you truly are only 11cm wide, even the numbers you are taking about will give you a significant risk of having 'side' boob, because they are significantly wider than your own breast. Be careful, because the wider you go, the more risk you have of visible and palpable rippling of the implants. Best. 

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

and stretch your tissue out in adverse ways so avoid them if at all possible.  The width of the implant will determine the width of your breasts but you cannot encroach too much on your sternum as there is a tendency for the implants to slide to the low spot you have there so your size may be limited by this problem.  As you have very little tissue, your implants will create your breasts so if you don't want balls, avoid the UHP.

Breast implants come in many different styles and sizes, which vary from manufacturer to manufacturer. 

Breast implants can consist of different filling materials inside a solid silicone polymer shell which can be smooth or textured. The implants can be round or contoured (anatomic) in shape.  The basic filling materials are:

Saline (sterile salt water)Memory Gel (silicone)Highly cohesive gel (firmer silicone)The most common implants used are the round silicone with a smooth shell covering.  These implants come in 4 basic styles:

Moderate ClassicModerate PlusHigh ProfileUltra High ProfileThere are 2 dimensions used when referring to these implant styles, base diameter and projection or height of the the implant.  As you go from the top to the bottom of my list the base diameter is less and the projection is more.  So, the Moderate Classic implant is almost flat, like a pancake, and the Ultra High Profile implant is more round, like a baseball. 

 Let's look at an example, a 400 cc in volume (12 ounces = 360 cc's) silicone breast implant, a very common implant utilized, and look at the dimensions:

Style                                       Diameter                              Projection

Moderate Classic                   14.5 cm                                3.2 cm

Moderate Plus                        13.1 cm                               4.0 cm

High Profile                            12.2 cm                               5.0 cm

Ultra High Profile                    10.6 cm                               5.4 cm

As you can see the Ultra High Profile has much more projection than the other styles and the Moderate Classic has the widest diameter.  The most common styles used are the Moderate Plus and the High Profile.  Women with a wide chest need a larger diameter implant and contrary to that, women with a narrow chest need a smaller diameter.  The implant choice is based on a women's anatomy, desires and the surgeon's experience and expertise.

Please see a Board Certified Plastic Surgeon who performs breast implant surgery frequently to assure the best possible result.  This is an outpatient procedure usually performed with a general anesthetic and a quick recovery.

Good Luck

Thank you for the question.  Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery. You have also been a question about communicating your goals. 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.









***Given that your surgery is coming up soon, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, 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 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 “more natural or hump” 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. 

You may want to look into a shaped implant.  There are always trade offs with differing implants but this may give you the shape you seem to be after.