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Examples of Dimensional Implant Sizing
Patient One

Examples of Dimensional Implant Sizing

Patient One

34 B cup to C cup

The first patient wears a small 34 B cup bra and wishes to wear a C cup bra. She wants a natural shape and presents desirable photos of moderately sized augmentations. She desires saline filled implants. Her breast width measures 12 cm and she has good soft tissue padding.

Now, let's check the saline implant sizing chart and see which implant will fit well. Start by looking at all implants that are about 11-12 cm in diameter. In doing so, we find a moderate profile implant with a diameter of 11.1 cm, a volume of 240-270 cc and projection of 3.8 cm. Also, we find an implant with a diameter of 11.6 cc, a volume of 270-300 cc, and projection of 3.9 cm. Either implant should fit well and achieve this patient's needs. She tries on the implants and favors the 240-270 cc implants, emphasizing that she wants a natural look. Therefore, 240-270 cc implants are the choice for this patient.

In this case the low profile implant with a diameter of 10.9-11.0 cm has a volume of 200-220 cc and is too small in volume. The high profile implant with a diameter of 11.0-11.1 cm cc has a volume of 320-340 cc and is too big in terms of volume.
 

34 B cup to D cup

Now, what if the same patient wanted a very large augmentation, say to achieve a D cup size? She "tried on" 430cc implants and felt that was the best volume.

In this case, high profile saline breast implants would be best, with a volume of 400-430 cc and diameter of 11.7-11.9 cm. The low and moderate profile implants of similar widths would be too small in terms of volume to achieve this patient's desired size.

Note: The appropriateness of such a large volume augmentation would need to be reviewed in terms of her breast anatomy, skin quality and tissue thickness. That is, she would need to have adequate soft tissue thickness to cover and support such a large breast implant.

Patient One

Examples of Dimensional Implant Sizing
Patient 2

Examples of Dimensional Implant Sizing

Patient Two

32 A cup to B cup

The second patient wears a 32 A cup bra. She wishes to wear a large B cup or small C cup bra and she desires silicone gel breast implants. Her breast width measures 11 cm. Her breast tissue padding is thin. Now let's check the silicone gel implant sizing chart to find an implant diameter of about 9.5-10.5 cm to fit this thin and narrow-chest woman.

The high profile implant with a diameter of 10.4 cm has a volume of 260 cc and should fit this patient well. During implant try on she likes the 260 cc implants the best.

The low profile breast implant with a diameter of 10.1 cm has a volume of 150 cc and is too small in terms of volume. The moderate profile breast implant with a diameter of 10.3 has a volume of 194 cc and is also too small in terms of volume to meet this patient's needs.

32 A cup to D cup

Now, what if this patient wanted a very large augmentation, say to achieve a D cup size? She "tried on" 425 cc implants and felt that was the best volume. The high profile silicone breast implants with a volume of 425 have a diameter to 12.0 cm.

Such implants would exceed the width of this patient's breasts by 1 cm. This would lead to distortion of breast shape and thinning of the tissues. This would especially be a problem in this patient given her thin tissue padding. Such an augmentation could be performed, but would put her at high risk for visible implant ripples and permanent tissue thinning. Before such a large augmentation would be performed the patient would need to clearly understand and accept the increased risks of the procedure due to the selected implant.

Patient 2

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Breast Implant Sizing

Breast Implant Sizing Should Be Fun

One of the most stressful experiences women feel while preparing for breast augmentation is selecting the size of breast implants to be used. This feeling is understandable, as implant shape and size will determine the look you have for years to come. However, we have great experience helping women through breast implant sizing and can make it clear and logical and actually a fun part of your surgery.

Cup Size

Like all of plastic surgery, breast implant sizing is an art and a science. To understand sizing, a number of factors must be considered. First is the aesthetic you wish to achieve. Aesthetics are often communicated in bra cup sizes, but more exact descriptions of desired breast shape and areas of fullness are important to consider. Often, a representative photo of desirable augmented breasts is useful to convey the look you want to achieve. Remember, each bra company calculates bra sizes differently, so using cup size alone as a parameter can lead to miscommunication between us.

illustration if property fitted implant

This breast implant fits the width of this breast nicely. Here the implant width (denoted by the upper set of arrows) is slightly narrower than the breast width. Breast width is measured from the cleavage area to the side of the breast (denoted by the lower set of arrows). Breast implants with a diameter about the same as the width of the breast fit most patients best.

Trying-On Breast Implants

Another useful approach is to "try-on" breast implants in a new bra you wish to wear and fill out with your breasts. Trying-on implants will give you and us a rough idea of the volume (measured in c.c.'s) range you need. You will have plenty of time to "try-on" implants during your consultation and pre-operative appointments at our office. Also, you can simulate implant try-on at home by filling your new bra with material and assessing your appearance wearing a variety of tops. But, please heed this caution: breast size may appear much differently after the implants have actually been placed surgically (compared to implant try-on), so you must not depend greatly on this approach for implant sizing.

Your Breast Size: In Breast Width

The next key steps in breast implant sizing are a bit more scientific. You need to know the dimensions of your breasts and chest. Think of these measurements as your real breast size. After all, when you try-on a new dress or pair of shoes you don't select any size at random and see how it looks. Rather, you select your new dress to fit your body and shape, greatly dependent on your predetermined size. Your key dimension for determining your breast size is the width of your breast. The breast width is measured (in centimeters) from the cleavage area to the outer part of your breast, next to your arm. This is measured in a straight line and is not curved around the arc of your breast. Most women's breasts are about 11-14 cm wide.

illustration for measuring implant size

Breast width is a key dimension for properly fitting breast implants to your body. The width is measured from the inner edge of the cleavage to the outer-most part of the breast. The tape measure is pulled tight and the distance is measured in a flat plane. The tape is not draped or wrapped around the breast to determine this dimension.

 Fitting Breast Implant Diameter to Breast Width

Once you know the width of your breasts you can now consider the dimensions of breast implants that would be best for you- An implant slightly narrower or about the same width as the width of your breast is usually a good choice and should fit you well. So, if your breasts are 12 cm wide, you should choose a breast implant with a diameter of about 12 cm. If your implant choice is within 1/2 to one centimeter of your breast width, you should do well. But, it is best to select an implant that is slightly narrower, rather than wider than your breast. So, in the case of a 12 cm wide breast, an implant with a diameter from 11-12 cm should be satisfactory.

Breast Tissue Thickness Is Important

Another important consideration is the thickness of the tissues of your breasts. A woman with thick breast tissues may be able to accommodate a wider implant than a woman with thin breast tissues. This difference relates to how the implant interacts with and stretches the breast tissues and skin, especially over time. In thin patients, wide implants are more likely to stretch and thin the tissues, leading to less padding over the implant and causing visible implant ripples.

Let's go back to our example of a breast that is 12 cm wide. If the breast tissues are very thin, then a narrower implant should be selected. So, an implant with a diameter about 10.5-11.5 cm would be best. During your consultation, Dr. Connall will perform a thorough breast examination which will include measuring your breast dimensions and soft tissue thickness. This information will then be used to help determine which implant would fit you the best.

illustration of improperly sized implants

Improperly fitted breast implants can lead to poor breast aesthetics. On the left, the narrow implant does not create nice cleavage or upper breast fullness. This leads to a "ball-in-a-sock" appearance. On the right, the implant is too wide and overwhelms the breast and normal breast aesthetics are lost. Also, wide breast implants can contribute to tissue thinning and implant visibility in the form of visible ripples.

Selecting A Breast Implant

With all of the key elements considered and evaluated you can then select a breast implant. To do this accurately, all three key dimensions of the implant must be considered. One is implant volume, which we have an idea of based on your desired cup size, your implant "try-on" size, and any photos of augmentations you like. The second is implant diameter, which should be slightly less than the measured width of your breast. The third implant dimension is outward projection, which generally follows according to the diameter of implant you need. But, if you desire a particular breast shape, the projection may be a more important objective to meet than diameter.

Breast Implant Matrix Sizing Chart

The Allergan Natrelle™ family of saline and silicone breast implant families layout nicely in a sizing chart that is based on the implant's dimensions. There, all of the available implants are listed in a logical format that allows an easy comparison between the different profiles of implants. The breast implants are grouped according to their "profiles" (or the amount of projection the implants have).

The saline implants are grouped into low, moderate and high profile styles. The silicone implants are similarly grouped into moderate, mid-range and high profile styles. However, please note that the moderate profile silicone group is very similar to the low profile saline group and the mid-range profile silicone group is very similar to the moderate profile saline group. The links below go to PDFs of each implant chart. We suggest that you print these charts and use them as we work through a few examples of implant sizing.

Consultation

If this is not completely clear, don't be concerned. Our team will review this with you during your consultation and will provide you with a copy of your examination (including all of your measurements) and a completed implant sizing form.

Intra-Operative Sizing

In some cases, the ideal breast implant size is not completely clear based on our pre-operative planning. Usually we have narrowed the choices to two different implants sizes, but you can't get totally comfortable with the selection. In these cases, we perform the ultimate implant try-on.

That is, Dr. Connall will try different implants in the O.R. This is a simple thing to do and only adds a few minutes to your surgery. Each breast implant has a corresponding temporary implant "sizer". These are inexpensive, disposable implants. After the implant pocket is surgically created within your breasts, the sizing implant is placed. Then the results are assessed by Dr. Connall and he chooses the size that is closest to your wishes. The sizing implant is removed and the permanent implants are placed.

In some cases, if we can't decide between different implant profiles pre-operatively, we will perform sizing with, say, a moderate profile implant in one breast and a high profile implant in the other breast. Once the correct breast implant profile and size are determined, the sizing implants are removed and the final breast implants are placed.

Words of Caution About Breast Implant Size

The size and aesthetics you wish to achieve with your breast augmentation are very personal choices and are up to you. However, many issues should be considered in determining your size. Such as:

  • Do I want my breasts to look natural; a little augmented; or obviously augmented?
  • How will my breast implants affect my lifestyle, such as athletic activities?
  • How will my breast implants affect available bra and clothing choices?
  • How will my breast implants affect the health and aging of my breasts?
  • Will my breast implants put me at high risk for having visible implant ripples?
  • Will my breast implants put me at high risk for needing a breast lift later in life?
  • Will my breast implants affect posture and lead to back and shoulder pain, such as can occur in women with very large, natural breasts?
  • Will the size I am choosing now be desirable for me 10 or 20 years from now?

As a general rule, very large breast implants will obviously look unnatural and will put you at risk for many of the problems listed above. That is, very large implants will likely cause accelerated aging of the breasts that may lead to sagging, tissue thinning, implant visibility (including visible ripples), and the need to re-operate to treat these problems. In severe cases, such problems may not be correctable with additional surgery.

We can help you with your breast implant sizing to reduce these risks. We have a lot of experience with implant sizing and have hundreds of happy patients. A big part of the successful results and the pretty look we achieve is based on the breast implant size and style we help our patients select. The average size implant used in our practice is about 330 cc. Larger sizes are certainly used, but typically do not we exceed 450 cc. The exact size implant to minimize risk to breast health is not known. But, as a general concept smaller breast implants are better, especially throughout the course of a woman's life.

But, "all of my friends have told me they wish they went with bigger implants." We hear this comment a lot from new patients. But, what most women don't discuss with their friends are the "nightmare" cases in which very large implants were used and problems occurred. Women don't tend to hear about the cases of women with very large implants that have had problems with rippling, sagging and corrective surgery. We think that if women shared these stories openly, then many patients undergoing breast augmentation would be less inclined to choose very large implants.

Breast Implant Size Is A Long Term Decision

Breast augmentation can sometimes be an experience of immediate gratification. We advise that you temper your immediate goals (which sometimes include having very large breasts) with the reality that this is a long-term life decision you are making. That is, think about how your breasts will look in the future, as much as how they will look in the first year after augmentation. We will help you through this process and try to help you make a wise choice. Please be assured: we are very good at this. The overwhelming majority of our patients are thrilled with their breast size after augmentation and we rarely return to surgery to replace a patient's implants due to undesirable size.

The Choice Of Breast Implant Size Is Yours

Ultimately the breast implant size you select is your choice. We respect your needs and your prerogative in making this very personal decision. Simply put- we are dedicated to providing you with the results you desire.