It is very difficult to determine the best lift you will need (recommended based on your photos) or 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 300 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. The same process goes for just filling in the upper part of your breast without becoming much larger. 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 as I will further explain in the link below including silicone vs saline implants
Thanks for the question and the goal photos, but without an exam no one here can help you pick specific implants. There are just too many variables and it takes an exam to get that answer. Vectra helps, wearing sizers is of little help as the implants look totally different in you than on you. If your doctor is experienced and artistic and you show him your goal photos and they are realistic (yours are) your surgeon should be able to find the implants that will meet your goal. If it is up to you to choose the implants, I would suggest looking for another surgeon. That's what he gets paid for.
Thank you for your question. There are several important considerations including your chest width, available soft tissue coverage, and the profile of implant desired. Higher profile implants can give a larger overall volume, with greater projection & a smaller width. However, these implants do not always lend themselves to a more 'natural' look. I use the Vectra 3D morphing program to help patients to understand the procedure, and the different looks that each type of implant can provide. Although not meant to represent actual results, it is an important teaching tool. We also used shaped gel sizers within a soft bra to help patients to visualize the relative contribution of each volume. Pre-operative 'wish' photos can give your surgeon an idea of your goals, and can facilitate a discussion in this regard. In the end, you have to trust the judgment of your surgeon. Many of us will use an operative sizer to determine the actual size of the implant to be placed, depending upon the needs at that time.
The most important determinant of the final "look" you get is the "profile" of the implant. A moderate profile is meant to look truly natural and a high profile is meant to look much fuller and less natural. There are other profiles as well. Once you know which look suits you best, using your base diameter, the proper size implant in that profile is selected.
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
Thank you for your question. There are very specific anatomic guidelines to help you and your surgeon choose the most appropriate breast implant for your unique breast shape and size.Most important is the base width of your breast. Your plastic surgeon will measure the base width of your breast and then consult a chart wwhich provides the base width of various sizes of breast implants. The most common implant profile was a moderate plus profile however if your base with cannot accommodate your chosen size and a moderate profile plus, larger volumes can be used in high profile or ultra high profile implants which have a narrower base.For more information on sizing please read the following Link:
The interpretation of
"natural looking" and what looks "too big" varies greatly from patient to patient and from
surgeon to surgeon.
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 you find a plastic surgeon certified by the American Board of Plastic
Surgery and ideally a member of the American Society for Aesthetic Plastic
Surgery (ASAPS) that you trust and are comfortable with. You should discuss your
concerns with that surgeon in person.
Robert Singer, MD FACS
The question you have asked is an excellent one! Although there some guidelines on how a breast implant size should be chosen, ultimately its your anatomy that dictates the size. Breast width is they key measurement on deciding the size of the implant. However, factors such as skin laxity and patient desires have an influence. Ultimately if you consult an experienced board certified plastic surgeon, you will be guided appropriately to the size that is right for you.Good luck!
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
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, and computer imaging) will be critical.
***Given your concerns, I would suggest that you schedule additional time to spend with your plastic surgeon communicating your goals, 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 “natural” or "C or D cup” to "grossly big" 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.