What would be best implant size for my breast width? Don't want them far apart, I have nice cleavage & want it to stay! (Photo)

Question

I went and saw a certified board PS and he said my BW is 15cm and I ha e about 150cc of my own tissue. He said I have a good selection of choice because of my BW. I liked the 475cc HP Round silicone but the base Diameter is 12.9. Will that be too small for my BW and make my breasts look too far apart?? I do not want to go with MP...i want HP. I also DO NOT want side boob. I like the shape of my breasts and how close they are...what implant will best enhance what I already have? Thank you!

Larry S. Nichter, MD, MS, FACS · Answer

t is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon.

Brian K. Reedy, MD · Answer

I don't think that an implant that has a smaller base width than your natural breast will make your result any less desirable.  You're right - you do have nice, natural cleavage.  An implant of a moderate size will simply enhance that cleavage and give you a lovely result.  Good luck!

Dallas Buchanan, MD · Answer

Thank you for your picture and questions. Without an in-person exam, it is hard to give you specific advice. That being said, if your BW is 15 cm and you are choosing a 12.9 cm width implant, that should be well within acceptable. The implant is not going to "space out" your breasts. Your breast dimensions are not defined by the implant, only enhanced. I think you are going to have an excellent result with what you have chosen.Best of luck!

Scott C. Sattler, MD, FACS · Answer

Your implant choice is reasonable - by not violating the width of your breast footprint, your augmentation result should be relatively 'natural' looking. High profile implants will place more implant volume and projection on a smaller implant diameter.

Mathew C. Mosher, MD · Answer

As others have replied, the breast base width measurement is only a starting point. This is not like getting fitted for shoes. Even the measurement of the base width will have some variability from surgeon to surgeon. Your existing breast base width does not appear to be 15 cm wide so this may represent what your surgeons believes is the best final base width after surgery. Your anatomy is very favorable for achieving a naturally looking cleavage space and fullness with a variety of implant volumes and projections. High profile implants of the volume you are considering will likely achieve a round and less than natural looking final appearance. Often the combination of traditional sizing combined with 3D imaging simulation can help you to understand what to expect. Best regards,Dr. Mosher

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The size of implant best or 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

Director-Beverly Hills Breast and Body Institute

#RealSelf100Surgeon

#RealSelfCORESurgeon

John Mesa, MD · Answer

Choosing the size of the breast implants is one of the most important aspects of the the breast augmentation procedure. Dissatisfaction always occur when the patient is unhappy with the size of the implants.In my practice is the patient, not the surgeon ( me) who chooses the implant size. In this way, my patients are always happy with the final result of their breast augmentation.Ideally the breast implant base size diameter should be ideally smaller and not bigger than then breast width. This will avoid the implant to extend beyond its perimeter and end up under the axilla, Breast implants base diameter changes with the projection: the higher the projection, the smaller the base diameter and vice versa.

Arko Demianczuk, MD · Answer

There are several factors to consider when selecting the ideal breast implant size. Breast diameter is one measurement, but your height is also important, as is the distance from your nipple to the fold. An implant measuring 475 cc HP would likely work in your situation, and will give a dramatic change in size.

Michael F. Bohley, MD · Answer

Thanks for you question. 15cm is a fairly wide breast width, which gives you many options for size. In that you already have very good natural cleavage definition, you should maintain this with a variety of different implant types/styles/volumes. Because the implants are centered on your natural nipple position, the wider the implant, the more lateral fullness you will achieve as well. Working with your local surgeon you should be able to come to an agreement on style/volume that will give you the aesthetic result that you're looking for. Best of luck to you.

Robert Singer, MD · Answer

The best cosmetic result in
any particular breast augmentation patient depends on a variety of factors,
including: your individual anatomy, desired outcome, 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. 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
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) or the Canadian Society for Aesthetic Plastic Surgery (CSAPS)  that you trust and are comfortable with. You
should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La
Jolla, California

What would be best implant size for my breast width? Don't want them far apart, I have nice cleavage & want it to stay! (Photo)

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