Is it okay to have an implant that is narrower than my chest?

Question

I am looking for a natural-looking but “blessed” breast aug & doctor suggested motiva demi 265cc - my breast width is 13cm and the implant diameter is 11cm - how does it impact the final look? Is it a standard practice to go narrower than the base? I have very slight tubular deformity. I’m 5’6 & 143 Ilb :) Many thanks!

Mathew A. Plant, MD, FRCSC · Answer

Not only is it ok, but it is the correct way of sizing implants. Proper sizing needs to account for the tissue that is already there, so that thickness must be subtracted from the measured base width in order to choose the right implant base diameter. Choosing an implant that is the same as the measured width will end up with an expansion of the breast laterally onto the chest and an oversized look, or it will result in a pocket that is too narrow for the implant and an oval shaped breast. Hope that helps!

John L. Burns Jr., MD · Answer

Preserve minimally invasive breast augmentation uses balloon dissection to preserve all your natural tissue.  Smaller implants are used to give results on par with larger implants placed using traditional augmentation.

Daniel Barrett, MD · Answer

Dear Mireda,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Sean Hill, MD · Answer

Answer from Dr. Sean Hill, Board-Certified Plastic Surgeon at Lone Star Plastic Surgery – Frisco, TX:
This is a fantastic question &mdash; and one I walk through carefully with every breast augmentation patient. The implant width in relation to your chest is key to achieving a natural and proportionate look.
⸻
✅ Is a Narrower Implant Okay?
Yes, it can be &mdash; especially if your goal is: • A natural breast slope • Subtle upper pole fullness • Less side spillage or width in tighter-fitting clothing • A result that fits your frame or athletic build without looking overdone
However, if an implant is too narrow, it might: • Leave a gap between the breasts • Fail to fill out your breast base completely • Limit your ability to achieve cleavage without a bra
That’s why it’s important to choose something that closely matches &mdash; but doesn’t necessarily exactly equal &mdash; your breast base width.
⸻

Donovan Rosas, MD · Answer

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
With regards to your specific question, undercutting your base width is always preferable to exceeding it. The reason for BW measurement is to ensure your implant is adequately camouflaged by the overlying soft tissue. Exceeding this limit will likely lead to an easily perceived implant behind the native breast.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and your surgeon create your custom surgical plan. 
As always, discuss your concerns with a board certified plastic surgeon.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Is it okay to have an implant that is narrower than my chest?  Yes. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Bianca Knoll, MD · Answer

often the base diameter of the breast implant is slightly less that the base diameter of the breast. Skin tightness, anatomy, and the desired outcome of the patient play an important role when discsussing a breast augmentation. There are cases where the base diameter can be pushed, but one should always respect the anatomical support structures of the breast. There shouldn't be any dogma about breast implant choices or techniques. But there is always a better and a less ideal choice for a patients individual situation. Knowing your options is key to make an educated choice.
I hope this helps.

Mats Hagstrom, MD (license on probation) · Answer

Each plastic surgeon will have their own way of judging what our appropriate implants in regards to breast implant diameter.
It’s not at all necessary to have an implant that is as wide as your breast is.
If your implant is as wide as your breast than the implant will expand and make your breast even wider than it currently is.
If the implant is placed under the muscle, then it needs to fit under the pectoralis muscle, which doesn’t have that much to do with your breast diameter.
 It’s generally technically easier to use a narrow implanted than a wide one.
This is especially true when using excessively large implants.
As long as you’re using modest size implants, then the chance of getting a good outcome is high.
You didn’t include pictures of yourself so we don’t know what your candidacy for the procedure.
Generally, speaking anytime, excessively large implants are used the chance of undesirable side effects, complications and need for revision surgery will always go up.
Would you describe it? Seems like a very appropriate way to go. 
There are a lot of variables to take in the consideration, and there are different ways of measuring breast diameter.
Best,
Mats Hagstrom MD.

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