Breast width 12.8cm implant width 13.2cm?

Question

The width of my breast measure 12.8. The implant I like has a width of 13.2cm with a 4.6cm projection (435cc) The one below that is 12.5 cm in width, 4.5 cm projection (385cc). The implants are Sientra Smooth Round Moderate Plus . I have read on this site that the implant should always be smaller than the breast. There doesn't seem to be that big of a difference between the sizes. Should I call and ask for one size down or will the original implant I picked be ok.

Steven J. Rottman, MD, FACS · Answer

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.

Steven Yarinsky, MD, FACS · Answer

As a rule of thumb, choose an implant diameter no larger than your natural preaugmented breast base width to get the most natural results. Choosing a larger implant can increase your risk for a "done" look and unnatural result as well as complications of a "double bubble" effect.  The volume difference between your two implants of 50cc is slightly more than 3 tablespoons of gel, a measuring cup of fluid is about 237 ccs of fluid. So for safety's sake and if you can live with 3 tablespoons less, you may wish to chose smaller implant.  The best option can be chosen only after reviewing this matter and your anatomy with your PS.  Best wishes for the best results!

Tom J. Pousti, MD · Answer

Thank you for the question.  There are no hard and fast rules when it comes to diameter of breast implant versus diameter of breast (band width). In other words, these measurements are useful but are only one of the many factors come into play when it comes to selection of appropriate breast implant size/profile.

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 (and continued concerns), 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 know words such as “natural” 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/video, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Barry M. Schwartz, MD (retired) · Answer

I have found that when a patient is choosing between two implants with one size difference it is almost always best to go with the bigger size rather than saying "I should have" Implants cab be bigger than the width of your breast and determining this depends on how natural or augmented you want to look.

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