How do I choose the right volume for my breast implants?

Implant augmentation is suitable both for women with "underdeveloped" breast hypotrophy and for those who have lost their gland as a result of pregnancy or weight loss. The procedure involves the insertion, through a small incision (under the breast, under the areola or in the axillary fossa), of a prosthesis placed either under your gland or under your pectoral muscle. A good assessment of your condition will enable you, after an initial consultation, to determine the access route, implantation site, type and volume of prosthesis best suited to your needs.

The question many women ask themselves: which volume to choose?

The choice of implant volume is the patient's responsibility, but Dr. Sylvain David is here to help.

Depending on the dimensions of your thoraxthe breast shape, of your size and your weight and above all your expectations I'd recommend it.

There are 2 methods to help you simulate the procedure:

Trial prostheses or templates:

During your consultation, you can try out various templates as a reference. 

Dr. David will insert the trial implants in a bra to simulate postoperative volume.

On average, Dr. David places breast implants ranging from 200 cc to 400 cc.

3D simulation by Crisalix:

Doctor David performs a 3D simulation of your breasts using a scanner and shows you the results.

The criteria used by the Doctor David to choose the ideal breast implant:

• It will determine the width of your preoperative breast and the ideal width of your postoperative breast.
• He will assess the distance between the two breasts and whether it is possible to bring them closer together by choosing the ideal implant diameter.
• Vertically, too, the diameter of the implant determines the height of the breast.
• The optimal implant projection will be determined by the patient's desired volume, the ideal implant diameter, and whether or not sagging skin needs to be tightened in the case of breast ptosis.
• In the case of tuberous breasts or tuberoid breasts "not having all the criteria of tuberous breasts", the implant volume must be adapted.
• Another criterion to take into account: the higher the breast, the greater the volume.

How can you avoid being disappointed by a breast size that's too small or too large?

At the consultation, you may bring any breast photos you wish.

2 consultations are required to determine your ideal breast volume using trial prostheses and 3D simulation.

Dr. David will also advise you on the ideal breast size based on the above-mentioned criteria.

Is there a risk in using implants that are too small?

If the breast implants are too small, the diameter may not be sufficient to reduce the gap between the breasts, and the breast may lack curvature.

Choosing a prosthesis volume that is too small may be responsible for certain imperfections, such as a wide intermammary valley (spread breasts), a lack of curves in the décolleté or in the lower and outer pole of the breast.

Is there a risk in using implants that are too large?

If the patient is too demanding, I may refuse to perform the procedure, as there are risks involved in fitting an implant that is too large.

• Unnatural result
• Breast too round at the top
• Excessive volume weighs on the lower part of the breast, causing it to droop ("ptosis").

Use of trial prosthesis to simulate postoperative volume

Pre-operative drawing

Horizontal and vertical breast base

Athletic patient requires a nice augmentation but wants a natural result 300 cc

Request a nice volume with a slight bulge at the top 340 cc

Very thin patient requires natural result 200 cc

Always adapt implant size to patient morphology

How do I choose the right position for my breast implants?

There are no automatic surgical strategies, as breast augmentation by prosthesis is a made-to-measure surgery.

Dr. Sylvain David generally uses the DUAL PLAN.

The choice of implant placement during breast augmentation will depend primarily on the thickness of the tissues (mammary gland and fat), the desired volume, whether or not there is breast ptosis, and whether or not the implant will be used.  other elements (plastic surgery as a complement to breast augmentation, etc.).

The advantages of breast augmentation with implants behind the pectoral muscle

A natural touch!

Each implant position has its advantages and disadvantages, but placing breast implants under the pectoral muscle has many advantages, and you'll find out why this "retropectoral" position is the one most often preferred during surgery. Placing the prosthesis behind the pectoral muscle makes palpation of the breast more natural, and the thickness of the muscle inside and at the top of the breast makes the implant less noticeable.

The advantage is obvious when the patient has a thin mammary gland and thin skin.

If the implant volume is "reasonable", placed behind the muscle, the breast implant is almost imperceptible to the touch in the upper part of the breast and internally.

When implants are placed on small-volume breasts, the fact that they are housed behind the muscle helps to protect them thanks to the maximum thickness sought (the thickness of the muscle is added to the thickness of the gland). This also ensures greater safety for the scar, which can be fragile depending on the volume implanted, particularly in the case of thin patients.

Two aesthetic advantages

- Smoother contours

The aim of breast augmentation is to achieve the most natural result possible, and thus to optimally camouflage the contours of the breast implant.

Choosing the location behind the pectoral muscle softens the contours of the prosthesis, particularly at the upper level, in the décolleté.

- Improved curvature and reduced subsequent sagging.

Implantation under the muscle provides better support for the prostheses, particularly when the augmentation is combined with ptosis correction (breast lift). This is due to the "hammock" effect conferred by the muscle on the lower part of the implant (the implant will thus be held at its lower base by the muscle), which will prevent any subsequent sagging of the breast.

The advantages of implants above the pectoral muscle?

Placing the prosthesis in front of the muscle can sometimes produce good results if the thickness of the gland is sufficient to camouflage the contours of the prosthesis.

In this case of retroglandular implantation (behind the gland and in front of the muscle), it is important to bear in mind that the thickness of the gland decreases over the course of the patient's life (menopause, pregnancy, dieting, etc.).

However, retro pectoral placement is not recommended for athletes. Under the effect of muscle contractions, there is an increased risk of displacement of the breast implants, particularly in the period close to the operation. In this case, the implants should be positioned in front of the muscle in sportswomen.

To improve the results of breast augmentation with a retroglandular implant, a fat transfer can be performed to soften the contours of the implant.

What are the disadvantages of breast augmentation under the pectoral muscle?

The "possible disadvantages" of placing the implant behind the muscle

Post-operative pain may last a few days longer than with retroglandular implantation, but is relieved by painkillers prescribed after the procedure.

There is no muscle weakness described in this case.