You have just decided to take the plunge and have a breast augmentation. There has been the back and forth deciding and listening to your friends and relatives telling you what to do but now you have finally decided. You have consulted with several good plastic surgeons but you still don’t know exactly how big you want to go or which implant is the best. Dr David Newman recommends that patients think more like a doctor when looking at breast implant alternatives. And there are two secrets that doctors know about breast implants.

Size Matters but Not Like You Think

Your Right Breast Implant Size is the Size That Will Make You Look Your Best

Plastic surgeons use volume to create shape. So when the volume of the implant is too small, there is not enough size to get to the best shape. For example, the implant needs to extend horizontally from the cleavage area to the outside of the breast in order that the cleavage will be the best it can be. If the implant is smaller than this, the cleavage will suffer. This is also true from the vertical perspective. The implant needs to have sufficient volume so that it can extend from the bottom of the breast to the upper pole or the upper part of the breast won’t be full and again, the overall shape will not be its best. These are both examples of the minimum volume required to achieve the best shape. 

But shape will suffer when the implant goes beyond a maximum volume. In other words, when the implant is too large, the shape won’t be as good as it was with a lesser size. This is mostly because the doctor has to make a larger pocket to hold the larger implant and the space required may extend beyond the natural edge of the breast tissue. When this is done, the breast starts to lose its “breast shape” and become more  “blobby”. Some patient might be willing to sacrifice some loss of shape to get to the size they wish but more often patients wish the best shape. But patients should know that there is a “best shape range of implant sizes” that will lend the best shape. There are some other issues that relate to creating a pocket that extends past the natural edge of the breast tissue. The breast tissue provides natural cover for the implant and hides the ability to feel or see edges of the implant (rippling). So when the implant goes beyond the edge of the natural breast tissue, it may be possible to feel the implant. 

Another issue relates to the support of the implant by the patient’s tissues. The implant is being supported by the pectoralis muscle which acts like an internal bra to push the implant up and that creates fullness of the upper part of the breast. We need good volume to have the implant “get to the top” of the breast to create this fullness but when the implant pocket is made too large or especially when the muscle is released at the bottom to put in a large implant, the muscle is no longer able to support the large implant and, over time, the implant that lacks support will fall and “bottom out”. This also results in loss of fullness of the upper part of the breast.  Most patients can get to their goal size wishes without having to go beyond this point. But it is interesting and helpful to discuss the fact that there is a “best size” or at least “best size range” for each patient and this is generally in the C to full C range though it can vary widely with different chest widths, different anatomy and different breast shapes. To find your best size range it is important to discuss your wishes with a plastic surgeon, both in terms of the size and the shape.  

A Plethora of Possibilities

While you are on the road to your best shape, it’s also important to know that there are several kinds of breast implants and not only one type. Breast implants can be round or tear drop shaped, have differing amounts of projection (sticking out from the chest), can be saline or silicone gel and even are offered with differing thicknesses of gel. This reveals something very important: there is no one best implant but rather different implants that each have pluses and minuses. Each patient must weigh the benefits of these different implants as they relate to their goals and go through the process of this decision. It’s a very enjoyable process to go through and find what is best for you! So don’t let anything hold you back.