A Plastic Surgeon Explains How to Choose Your Perfect Breast Implants

Dr. Hess Explains How to Choose the Best Breast Implant for You

As a board certified plastic surgeon with over 16 years of experience, I have helped numerous women achieve their dream breast augmentation results. Getting beautiful results that last for years isn’t easy, but working with a board certified plastic surgeon who will take the time to help you find the breast implants that best fit your body, lifestyle, and aesthetic desires will set you up for success. In this post, I’ll discuss why your results depend on the right breast implants, and how a plastic surgeon can guide their patients in making the best choice for them.

Empowering patients to make the right choice

Choosing to undergo a breast augmentation is a big decision, and with all the details involved, it can be tempting to let your plastic surgeon choose your implants for you. Don’t get me wrong, I’m not saying you shouldn’t follow your surgeon’s implant advice; rather, you should actively participate in the discussion so you can feel confident you are making an informed decision versus simply taking someone else’s advice without careful thought. Remember that while your plastic surgeon may be an expert in breast surgery, they are not yet experts in your lifestyle and particular aesthetic goals!

My patients may try on as many as 15 to 30 pairs of implants before their augmentation, which makes our practice very unique.

As a RealSelf Top Contributor, I have noticed that it is surprisingly common for plastic surgeons to give their patients choices for implant volume and profile but actually choose the final implant size for their patients either preoperatively or in the operating room. I prefer to empower my patients to choose the perfect breast implants long before they reach the operating room. After all, by the time you arrive at my office, you’ve likely been thinking about what your breasts should look like after surgery for a considerable amount of time.

My job at the implant-choosing stage is to be your guide. I encourage my patients to look at, feel, and try on as many implants as they want before surgery to make sure they are fully happy with their implant choice. My patients may try on as many as 15 to 30 pairs of implants before their augmentation, which makes our practice very unique in the plastic surgery world.

Using breast implant sizers versus requesting a cup size

Many of my patients are surprised to find that I actually discourage them from focusing on their desired cup size during the sizing process. This may sound counterintuitive, but bra cup sizing is notoriously unreliable: you may wear a C cup in one brand or style and a DD in another, meaning you’re not comparing apples to apples when discussing bra cup sizes with your surgeon. Also, the number of cubic centimeters (cc’s) needed to move up a cup size can vary widely depending on a patient’s existing breast size and shape. That said, size is an essential piece to achieving successful breast augmentation results, and implant sizers are your best friend when it comes to finding your perfect size.

What are breast implant sizers made of?

Implant sizers are actual sample breast implants used to give patients a sense of what their breast size may look like after surgery. They are made of the same material as actual breast implants (allowing you to get a feel for silicone vs saline fills) and are available in a variety of sizes and styles.

How can I get the most out of my implant sizing session?

When you come to your plastic surgeon’s office to try on implants, I recommend bringing several outfits with you so you can better understand how different implant sizes will look and feel in various clothing.

I think it’s important to wear a tight sports bra while trying on sizers, as this helps unite the sizers with your existing breast tissue and thus provides a more accurate idea of your potential post-surgical breast size.

Note: one of the major downsides of sizers is that they tend to sit lower in the bra than surgically-placed breast implants, therefore your surgeon should guide you while trying them on.

Should I go bigger?

While my overall goal is to help patients find a size that feels comfortable and complements their natural figure, I advise my patients who are stuck choosing between two similar sizes to go with larger implants, as the number one non-medical reason for breast revision surgery is to switch to bigger implants.

Why breast implant shape matters

Round implants are the most common breast implant shape thanks to the fact that their round, unstructured shape can create a visually-pleasing result in a variety of patients. They can also provide more fullness in the upper portion of the breast (referred to as the upper “pole”) than comparably-sized “shaped” form-stable implants. Both saline and silicone fill options are available for round breast implants.

However, round implants are not for everyone. For patients with minimal natural breast tissue, I sometimes recommend shaped, or “gummy bear, implants because they have a form-stable teardrop shape (meaning they hold their form and are contoured at the bottom & tapered at the top). This structure helps them look more natural on slimmer women with smaller breasts. Available in cohesive silicone gel only, shaped breast implants provide a firmer feel than round breast implants.

Textured vs. smooth implants

All breast implants, regardless of fill type, have a silicone shell that is either smooth or textured. As their name implies, textured implants have a texture applied to prevent them from rotating in the breast implant pocket; this is particularly important for shaped implants that have a slimmer top and fuller bottom and must stay right-side up. Round implants, on the other hand, often have a smooth shell, as rotation within the breast implant pocket will not affect the appearance of the breast.

Textured implants have recently declined in popularity because certain highly textured implants have been associated with a very rare form of lymphoma, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). One particular line, Allergan’s Biocell breast implants, was recalled over this risk. It’s important for patients to be aware that not all textured implants are implicated and those with more standard shell textures have been safely used for years.

For the majority of patients, I recommend smooth implants, as they provide beautiful results and are offered in a wide range of sizes and profiles. In cases where a patient wants textured implants or I think they will provide the best result, we can choose textured implants that have been shown to have the lowest risk.

Considering breast implant profile

A common misconception is that the word profile determines how high or low on the chest the implant is placed. This is not true; when it comes to breast implants, the word “profile” refers to how much your breast implants will project outward from your chest.

The 380 cc implants that were perfect for your friend might not be right for you: if your breast width differs by just a few centimeters, you would need a different amount of cc’s to get a similar end result.

Note that implant profile isn’t tied to implant size because implants are made in a range of widths to fit patient breast measurements. Imagine two 380 cc implants where one has a 12 cm base and the other has a 16 cm base. The one where the same amount of ccs is constricted to a 12 cm base will be taller than the implant where the 380 ccs is allowed to spread over a 16cm surface. In other words, the narrower the implant base is, the greater the projection will be.

This is also why the 380 cc implants that were perfect for your friend might not be right for you: if your breast width differs by just a few centimeters, you would need a different amount of ccs to get a similar end result.

Why does breast width matter?

Breast width is critical for properly fitting implants to your body and is measured individually for each breast. It’s often said that breast implants with a diameter that is the same width as the breast fit best, but I believe in selecting in implants that are slightly narrower than the breast: years of correcting other surgeon’s poor results have shown me that overly wide breast implants can contribute to tissue thinning and implant rippling. That said, too narrow an implant can look unnatural, making it critical that your plastic surgeon understand the nuances of implant width choice.

High profile breast implants

High profile implants work best in women who want a large, curvaceous bust because they provide more upper pole fullness and therefore increase cleavage. High profile implants can create very aesthetically-pleasing results for women who have narrow breasts and a good amount of natural breast tissue; the outcome is breasts that appear rounder while maintaining a good amount of projection.

Low profile breast implants

Low profile implants are ideal for slimmer women with wider chests who are physically active and don’t want to be impeded by large breasts. They allow you to increase fullness with less projection, creating a natural-looking breast that won’t get in the way at the gym. Low profile implants can also work well for women with wide breasts that want to maximize volume at the edges of their breasts, especially in the cleavage and upper pole, without increasing projection.

Moderate profile breast implants

Moderate profile implants tend to be ideal for most of my patients, as they create well-proportioned, natural-looking breasts. With just the right amount of projection, moderate profile implants are a safe choice if you’ve tried on both high and low profile implants and still aren’t sure which is best for you.

Choose Dr. Hess for your breast augmentation

Let board certified plastic surgeon Dr. Christopher L. Hess help you choose your perfect breast implants. With over 16 years of experience performing breast augmentations in northern Virginia and the Washington, DC area, Dr. Hess has the knowledge, skill, and experience to help you achieve your dream breast surgery results. Contact Dr. Hess online or call our practice at (703) 752-6608 today.

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