BWD: What It Is and How It Affects Breast Implant Size

Breast width diameter, or BWD, is arguably the most important consideration in choosing the breast implant that is perfect for you. But what exactly is BWD? How do you measure it? How is it used to determine your breast implant size? We answer these questions and more.

What Is Breast Width Diameter (BWD)?

Breast width diameter (BWD) is the measurement of the base width of your breast. Usually taken by a plastic surgeon with a caliper, this measurement is taken against your breast base at the chest wall. It measures the width of your breast from the cleavage to the outermost edge. Each woman has breasts that are shaped differently—some women have a defined breast base while others do not. Because of this, you may find that surgeons at different consults have different measurements, but usually they will be close to each other. This measurement is taken in centimeters for easy matching to the diameter of breast implants.

Preoperative measures include SSN:N (suprasternal notch to nipple), BW (breast width), BH (breast height), IMD (intermammary distance), and N:IMF (nipple to inframammary fold).

The Importance of Breast Width Diameter (BWD)

Your BWD measurement is important because the natural width of your breast helps your surgeon determine the implant width that will work best for your anatomy. The width of your breast implant is important to the final look of your breasts. Sticking close to your natural measurements is usually what is going to result in the most natural looking augmentation for you. A general rule of thumb is to use an implant that is within 1cm of your natural measurement, but of course this can vary based on your individual anatomy. Natural factors in your anatomy that may change how a surgeon uses your BWD measurement are things like natural symmastia (tenting of the skin between the breasts), Poland’s Syndrome, pectus excavatum, and pectus carinatum.

How BWD Will Affect Your Breast Implant Selection

Let’s use an example to work through how your BWD will affect implant selection for a sample patient. The plastic surgeon measures a patient's BWD to be 12.5cm. During the consultation process, she discussed her desired look and size, even showing photos of the breast shapes she like best. The surgeon recommends sizes for saline and silicone implants. Using the Mentor implant size chart, the surgeon gives her options for implant sizes in a moderate plus and high profile silicone and moderate profile saline. She can then try on sizers to determine the profile and cc size that she prefers on her body.

Sample patient

12.5cm BWD

Mentor mod+ silicone, 300-400cc

12.0-13cm width

3.6-4.0cm projection

Mentor HP silicone, 400-500cc

12.3-13.2cm width

5.1-5.4cm projection

Mentor moderate saline, 325-475cc

12.1-13.5cm width

4.3-4.9cm projection

The chart shows that there are a lot of options! Not all of these options will be perfect, but one will be recommended for the result you are looking for based on your anatomy and desired look. As the chart shows, changing profiles from moderate plus to high profile would allow this patient to go as low as 300cc or as high as 500cc implants. This is quite a variable range and will result in a visible size difference between these sizes. The BWD measurement is the guide to help determine the width needed and the cc size options available to each patient. Open discussion between the patient and surgeon is essential in the choice for what profile will result in the desired look.

Choosing a Breast Implant Outside of Your BWD Measurement

What happens if you choose an implant that does not align with your BWD measurement? Choosing too small can result in an implant that does not properly fill the width of the breast, resulting in cleavage that is too wide and unnatural looking. Choosing an implant that is too wide may result in cleavage that is too close, or symmastia. It can also result in breasts that are too wide, pushing farther off the side of the chest wall than the desired look of the patient. In some cases the implant may slide sideways off the chest wall toward the armpit, or lateral displacement. Both of these complications require surgery to repair and, in the case of symmastia correction, it can be quite complicated to fix.

The final complication that may result from an implant that is the wrong width involves the placement of the implants in relation to the nipples. An implant that is too narrow may be placed closer to the cleavage, causing the nipples to point outward. An implant that is too wide may be placed further apart, causing the nipples that point towards each other. Oftentimes switching the implant out for one that better matches the BWD measurement is required to fix this cosmetic complication.

Created November 2016

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