What role does BWD play in breast aug?

Thanks for your question. Breast width is an important consideration when choosing implants. If you choose implants that are much wider than your breasts they could cause problems like synmastia (lack of a gap between the breasts) or visible rippling in the cleavage and "side boob" areas. On the other hand, choosing implants that are much narrower than your breast width can also look odd. For example, if a patient with wide breasts chooses high-projecting implants with a narrow base, they can look like prominent lumps rather than naturally filling in each breast. Although there is no universally-accepted implant sizing method used by every surgeon, in my practice I usually recommend implants that are a little smaller than the person's BWD. This ensures that there is breast tissue covering the implants, yet they still fill out the existing breast shape. However, there are exceptions to every rule. For example, some women have very small, widely-spaced breasts (such as tuberous breasts). In this case it may be better to accept the risk of inserting implants that are wider than the breasts, to help create a more proportionate appearance. Implant selection is a balance between choosing implants that are large/wide/full enough to meet the patient's goals, while considering the risks/disadvantages of inserting implants that may not have sufficient tissue coverage.

Dear Fabulous50618,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery