During a breast augmentation consult, most experienced breast plastic surgeons such as Dr. Andrade will take detailed measurements. This blog will help demystify these measurements, and help patients understand how they affect breast implant selection.
Breast base width (BBW)
This measurement is also termed breast width diameter (BWD). It helps the surgeon determine the diameter of implants that will best fit within the person’s breasts. There is no universally accepted protocol for sizing breast implants but in Dr. Andrade’s practice, patients are most often advised to choose implants with a diameter that is a little smaller than their BBW. If the selected implants are much narrower than the actual breasts, they can look like unnatural mounds in the middle of each breast. On the other hand, if the chosen implants are wider than the actual breasts, complications can arise. For example, there might be visible implant rippling on the outside of the breasts in the “side boob” area, or a raised tissue bridge between the breasts, which is called synmastia. It is possible for patients to pick implants that are proportionate to their BBW yet go larger or smaller in volume, by selecting implants with a different profile. For example, a patient with a BBW of 13cm might choose 12cm diameter Low Profile implants if they want a modest increase in size, but choose 12cm diameter Extra Full / High Profile implants if they wanted a major boost in fullness.
Sternal notch to nipple (SN-NAC)
The sternal notch to nipple-areola complex distance is taken from the bony notch at the top of the breast bone (which can easily be felt at the base of the neck) to the centre of the nipples. This measurement is important because it helps to determine if there is nipple asymmetry or sagging. It is very common to have minor asymmetry of 1-2cm, in which case most patients choose not to have any corrective surgery. However, if there is significant asymmetry and it bothers the patient, breast lift (mastopexy) surgery can be done to elevate the lower areola. If there is significant sagging on both sides, the SN-NAC measurement is typically much longer than the average of 21cm. In this case, bilateral implants + lift (augmentation-mastopexy) might be recommended to correct the nipple position and reshape the breasts.
Nipple to inframammary fold (NAC-IMF)
Measuring the distance from the nipple to the fold under the breast is very important, as it significantly impacts surgery and the cosmetic result. Sufficient tissue must be below the nipple to expand and accept a breast implant. If there is minimal tissue, the implant will tend to sit too high on the chest. A common way for surgeons to help correct this issue is to adjust the breast implant pocket internally to make it lower on the chest, which also lowers the existing fold on the breast. Although this technique usually works well, problems such as “bottoming-out” or “double-bubble deformity” can arise. These risks are always discussed with patients who require adjustment of their NAC-IMF distance.
Internipple distance
This is the measured distance between the nipples. This measurement is not typically adjusted during surgery, but it is still helpful to explain to patients. For example, if the nipples are wide apart on the breasts and point to the sides, inserting breast implants will not correct this appearance. Taking time to explain a person’s pre-existing nipple position on the breasts helps to ensure their goals for the outcome are realistic and achievable.
Areola diameter
It is important to measure the areolae and determine if the patient wishes to make them smaller during surgery, which would involve areola reduction surgery (periareolar mastopexy). The majority of patients seeking breast augmentation surgery do not wish to change their areolar diameter. After breast augmentation surgery, the areolae might become larger.
Hopefully this overview has provided insight why all the measurements taken by Dr. Andrade are so important. Dr. Andrade and his entire clinic team have gained a reputation for helping choose implants that achieve their size goals, yet still match their body type to minimize the risk of postoperative problems. We have overwhelmingly positive breast implant reviews from satisfied patients on Google, RateMDs, and RealSelf.
Disclaimer: This information is meant for Dr. Andrade’s patients and to supplement an in-person consultation. Medical science is constantly changing, so it is not guaranteed to be complete or accurate.
