Posted by Dr. Hardesty
Choosing the correct breast implant is multi-faceted depending on your anatomy, skin elasticity as well as desired look and size. Breast size is a very personal choice, and using a variety of techniques (some of which you may have completed), you can achieve the size and look you desire. For example, some people like to drive Hummers, others sports cars; some prefer dark-colored cars, others white.
Unfortunately bra manufacturers haven’t standardized cup sizes. Breast implant manufactures have created a wide spectrum of implants based on a cubic centimeter (cc) measurement system. Different base widths result in different projections for the same size of cc’s. Different shapes are based on the cohesiveness of the internal gel.
My suggestions are:
- Purchase several bras (full-bodied without padding) of the size you think you want to (You may realize there are no standard bra [cup/strap] sizes.)
- Take a measuring cup (1 ounce = 30 cc) and place rice in a nylon pantyhose stocking.
- Try on various volumes of rice with some form-fitting clothes.
- If implants are placed in the sub-muscular position, I personally add 10 percent additional volume to compensate for the muscle flattening the implant secondary to muscle compression
Select several nude model photos of the goal breast shape you desire. The implants’ placement decision (sub-pectoral, dual plane or supra-pectoral) will be determined based on your anatomy. If the implant is placed under the pectoralis muscle, I usually add 10 percent volume to what the patient chooses to
compensate for the muscle pressing down on the implant and for the naturally settling of the implant, which often
makes the breast appear smaller two to three months after surgery.
For the same volume, the higher the profile the narrower the base width. There is very little difference in projection between a moderate to high profile implant, thus little effect on the perceptible final projection of your breasts. The base width of the breast should equal the base width of the implant. Thus I personally choose the profile based on the patient’s chest measurements (a high profile on a wide chest may not result in the cleavage desired, and conversely a low profile on a narrow chest may result in an implant being in the outside arm area).
- Round (actually elliptical in shape)
- Anatomical or shaped (form stable), which are mainly used in breast reconstruction.
There are four companies that produce breast implants: 1) Mentor; 2) Allergan; 3) Sientra; and 4) Ideal. Each of these have various dimensions based on the volume:
- 1-2 = silicone fill comes from same factory
- 3 = silicone gel has highest cohesiveness (gummy bear) for round implants
- 1 = only implants made in the United States
- 1-2 = make both silicone and normal saline-filled implants
- 4 = only makes normal saline-filled implants
- 4 = has internal baffles in the normal saline-filled implant to give a feel more like silicone-filled implants
- 1-4 = all FDA-approved (U.S. Food & Drug Administration)
In future blogs, we’ll discuss other factors such as the difference of silicone gel-filled and normal saline-filled implant as well as incision sites and sub-pectoral (under the muscle) versus supra-pectoral (on top of the muscle) implants.
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