When you go for your consultation for breast augmentation there are really 3 key decisions you have to make, other than the decision to actually do it or not. These 3 are implant type, saline vs silicone, implant placement, above or below the muscle, and implant size. What constitutes “too big” is a fairly subjective answer in some ways and in others there is a well defined answer to the question. The subjective component is patient based. In other words, you need to decide how you would like to look. Do you want a very subtle change, something in the middle, or do you want the result to look obvious. Most of my patients simply want to balance out their figure and will choose an implant size that accomplishes that. In fact, a lot of my patients don’t look very different in their clothes after surgery because they had been wearing bras with so much padding they were already ‘augmented’ via their bra choice. Now, if you ask me what is “too big” I am looking at things from a completely different perspective. For the surgeon, the key issue is the base width of your breast. Base width is the measurement from the top of the breast down to the crease and from the edge of your breast bone to the side of the breast. In most women the width of the breast will range from 13 to 14 cm on the small side up to 16 or 17 cm. A base width of about 15-16 cm is considered “normal”. The reason that this measurement is so critical is that in order to achieve the most natural results I need to use an implant that will fit within the breasts natural boundaries. When you exceed the boundaries it is fairly obvious. When the implants are under the muscle, there is only so much room between the nipple and where the muscle inserts onto the breast bone. So, for instance, in a woman with a 14 cm breast width, there is only 6 or 7 cm of space between the nipple and the breast bone. If we use an implant that is 14 or 15 cm wide there is simply no room to center the implant behind the nipple. The only place the implant can go is further to the side which translates to under your arm. Like wise, if the distance from the nipple to the crease is limited, the mid point of the implant will be above the nipple giving the look of an implant that is too high. My goal, in order to give you the most natural result, is to center the implant directly behind the nipple. Thus, choosing an implant whose width matches that of your breast is critical.
Lee Corbett, MD
Medical Director, Corbett Cosmetic Aesthetic Surgery and MediSpa