Breast Augmentation - Implant Shape and Size

from plastic surgery

Implants may be teardrop-shaped or round. Round implants are shaped like a hamburger bun. Teardrop implants have greater fullness in the lower half and less fullness in the upper half.Deciding upon the right implant size can be the most challenging part of this operation. This is because cup size is not standardized. It varies among bra manufacturers and also among a single manufacturer's products.

Implant Shape - Teardrop

Because the breast has greater fullness toward the bottom, some plastic surgeons prefer teardrop implants. They have found that teardrop implants provide a more natural result. Other surgeons think that the teardrop shape makes no difference, particularly with regard to saline implants, because as the body heals, it forces the implant into a round shape regardless of how it started.

Because of their design, teardrop implants must be oriented under the breast with the fullest portion at the bottom of the breast. One problem with teardrop implants is that they may rotate following surgery. This results in a sideways or upside-down appearing breast. To reduce the risk of rotation, teardrop implants are textured; however, risk of rotation is still about 10 to 20 percent. Teardrop implants usually cost more than round implants. Because of these drawbacks, the plastic surgeons who use teardrop implants tend to reserve them for women with extremely little or no breast tissue, as these women might otherwise appear too "round" in the upper half of their breasts.

Implant Shape - Round

Round implants have several advantages. They may rotate freely under the breast without aesthetic consequences, they may be textured or smooth, and their cost is lower. Because the contents gravitate to the lower pole of the implant when a woman stands, the lower pole will naturally become fuller, thus negating the need for a teardrop implant.

Implant Size

Deciding upon the right implant size can be the most challenging part of this operation. This is because cup size is not standardized. It varies among bra manufacturers and also among a single manufacturer's products. For example, the cup of a 32C bra is smaller than the cup of a 34C bra, even when made by the same company. So telling your surgeon which cup size you desire may be of limited help. Some surgeons may ask your desired cup size to get a general idea of your goals. Do not misinterpret this as a guarantee of the final size.

Typically, implant sizes range from six to eighteen fluid ounces, or 200—600 mL, although larger and smaller implants are available. Implants are manufactured in 25—30 mL increments. As the volume of the implant grows, so does its diameter and projection.

Tips for Selecting Size

There are a number of factors to consider when selecting implant size.

• It might be useful to discuss proportion with your surgeon. Many women seek augmentation to make their breasts proportionate to the rest of their bodies, in which case your surgeon may measure your breast diameter to select an implant size that provides a proportionate augmentation. Others might want their final size to be either larger or smaller than the proportionate size. Of course, one drawback of this approach is that your concept of proportion may be very different than your plastic surgeon's.
• Ask your surgeon for breast implant samples or sizers. You can place these in your bra to help you determine the best volume. You may also use water balloons that are filled to various volumes (a more arduous task). If your plastic surgeon has sizers, be sure to wear a tight sports bra (or two), as doing so makes the sizers more accurate. Incidentally, plastic bags filled with rice are not very useful for sizing, as they do not conform to the shape of the breast.

• Breast augmentation with various sized implants. Note that final size is influenced by implant size, preoperative breast size, and body size, (a and b) A forty-three-year-old woman who is 5 feet 2 inches and 115 pounds before and after placement of saline implants under the muscle: both 240 mL. (c and d) A twenty-three-year-old woman who is 5 feet 2 inches and 128 pounds before and after placement of saline implants under the muscle: 310 mL right, 280 mL left, (e and f) A twenty-year-old woman who is 5 feet 8 inches and 130 pounds before and after placement of saline implants under the muscle: both 360 mL. (g and h) A twenty-one-year-old woman who is 5 feet 1 inch and 107 pounds before and after placement of saline implants under the muscle: both 375 mL. (i and j) A twenty-three-year-old woman who is 5 feet 6 inches and 125 pounds before and after placement of silicone implants over the muscle: both 500 mL high profile, (k and I) A thirty-one-year-old woman who is 5 feet 4 inches and 135 pounds before and after placement of saline implants under the muscle: both 510 mL. Cm and n) A thirty-two-year-old woman who is 5 feet 10 inches and 135 pounds before and after placement of saline implants under the muscle: both 650 mL.
• Although 30 mL sounds like a lot, it is not. It is merely a fluid ounce. So if, for example, you are struggling between a 360 mL implant and a 390 mL implant, you should stop torturing yourself. They are so similar that if you like one, you will also like the other. Conversely, if you end up deciding (after surgery) that the 360 is too small, then the 390 would also have been too small. Once you have narrowed your selection down to two or three sizes, I recommend you choose the largest among them, as this is associated with greater satisfaction in the end.

Pitfalls in Size Selection

The following are not necessarily useful ways to select implant size:

• Aviod relying on photos of other woman: this can be very misleading, especially when height, weight, and chest diameter are different from your own.
• Avoid lingerie ads: there is no way to tell which size implant will give the size proportionate to that seen in an ad.
• Do not request the same size implant as a friend whose implanted breasts appear aesthetic to you: this simply does not work unless you are identical twins.
• Do not select a smaller implant than you desire with the hope that "no one will notice." Those who do often later complain, "But no one noticed!"
• Do not select a size larger than you like because "everyone on the Internet said they wished they had gone larger." Be honest with yourself while trying sizers, and you will most likely select an appropriate size.