Understanding breast implant sizes: how to make the right choice

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Good news: there are a LOT of options now for breast implants, which makes it easier to choose the size and shape that is best for each individual. The not-so-good news is that having so many variables can make it more confusing. Here is how to simplify the process and improve the odds of knowing that you made the best choice for your goals and your body.

I will be talking primarily about round implants, since I rarely use the shaped (“teardrop”) implants anymore. There are three aspects to consider: size (volume),

projection (profile), and diameter. Any two of these determines the third; for example, if you know the diameter and size then you know the profile. A low profile implant will be wider than a moderate or high profile implant of the same volume. Conversely, a high profile implant will be narrower unless the volume is much larger.

Breast diameter is the most important consideration

The most important variable is the width of the breast, which we call the base diameter. This determines the diameter of the implant. The implant cannot be wider than the breast, and if it is a lot narrower then it won’t look right. Too narrow of an implant will leave a wide gap between the breasts. A simple measurement of the breast width is all it takes to eliminate most of implants from consideration. If we are going small, then it’s a low profile, large a higher profile, and a few options in between.

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breast implant profiles

Though simple in concept, there is a bit more to it. For one thing, each manufacturer uses slightly different terminology. Allergan’s Natrelle line has 5 profiles: low, low plus, moderate, full, and extra full. Sientra

extra full. Sientra comes in with low, moderate, moderate plus, high, and extra high. Mentor goes moderate, moderate plus, high, and extra high. The moderate profile implants from Sientra and Allergan are pretty similar, but closer to Mentor’s moderate plus. My suggestion is to focus on size before profile, because profile will be determined by the size you want and the width of your breasts.

Other limitations may apply besides breast width. For example, if the breasts are small and the skin envelope is tight, a large implant isn’t going to work. In the opposite situation, with a loose skin envelope, it may be necessary to use a larger implant or do a breast lift.

Example: This patient desired medium to full breast implants. The VECTRA 3D analysis shows an external breast base diameter of 12.9 cm. Allergan moderate profile implants, 275 cc with a base diameter of 11.5 cm were selected (implant diameter needs to be less than external breast diameter).

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