Selecting the correct pectoral implant size is primarily based on the patient’s chest dimensions, tissue thickness, desired projection, and aesthetic goals — not simply implant volume alone.
The most important concept is that implant width must fit the chest wall anatomy first, and projection/volume are chosen second.
Key Measurements Used in Pectoral Implant Sizing
1. Upper Chest Width (Clavicle Length)
Upper width of the pectoralis muscle at the level of the upper axillary crease
The implant should fit:
- From the parasternal border medially
- To the anterior axillary line laterally
- Without extending into the armpit
Typical male chest widths:
- Small frame: 13–14 cm
- Average: 15–16 cm
- Broad chest: 17+ cm
2. Lower Muscle Width (Base)
Smaller than superior width
Thin patients:
- Need lower projection
- Need softer transitions
- Are at higher risk for implant visibility
Thicker/muscular patients:
- Can tolerate larger implants
- Better conceal implant edges
- Can support higher projection
3. Medial Sternal Height
Implant Projection
Projection determines how far the chest projects outward. Typical projection ranges:
|
Implant Type |
Projection |
|
Subtle athletic |
2–3 cm |
|
Moderate enhancement |
3–4 cm |
|
Large augmentation |
4–5 cm |
|
XL/custom |
5+ cm |
Higher projection increases:
- Upper pole fullness
- Side profile prominence
- Risk of edge visibility
Chest Shape
The implant should match:
- Flat chest
- Convex chest
- Barrel chest
- Asymmetric chest
Broad/barrel chests generally need:
- Wider implants
- Lower profile shape
Flat narrow chests often require:
- Narrower base
- More projection
Typical Implant Volume Ranges
|
Patient Goal |
Approximate Size |
|
Mild athletic enhancement |
200–300cc |
|
Standard cosmetic augmentation |
300–450cc |
|
Large augmentation |
500–650cc |
|
XL/custom look |
700–900cc+ |
Volume alone is misleading because:
- Different implants have different widths
- Projection varies
- Shape changes visual effect dramatically
How Surgeons Commonly Select Size
Method 1: External Chest Measurements
Measurements include:
- Sternal notch to nipple
- Nipple-to-nipple distance
- Chest width
- Soft tissue thickness
These measurements determine the maximum safe implant footprint.
Method 2: Sizers
Temporary external sizers or intraoperative implant sizers help visualize:
- Projection
- Width
- Symmetry
Method 3: 3D Imaging
Some surgeons use:
- Vectra 3D simulation
- Digital morphing
- Custom CAD design
Especially useful for:
- Bodybuilders
- Asymmetry
- Poland syndrome
- Custom implants
Important Principle
A good pectoral implant should look like:
- Developed pectoralis muscle
- Natural lateral taper
- Smooth upper chest transition
Not:
- Round breast implants on the chest
- Overly spherical fullness
- Excessive medial fullness
Common Sizing Mistakes
Choosing by Volume Alone
“800cc” can look very different depending on:
- Width
- Height
- Projection
- Chest anatomy
Oversizing in Thin Patients
Can cause:
- Implant visibility
- Palpability
- Animation deformity
- Tissue thinning
Ignoring Arm Movement
Very wide implants may distort during:
- Bench press
- Flexion
- Arm elevation
Practical Sizing Strategy
A common approach:
- Determine maximum safe width
- Select implant height
- Choose desired projection
- Match volume to anatomy
- Test with sizers or simulation
Example
Broad athletic male:
- Chest width: 16 cm
- Good muscle coverage
- Wants noticeable enhancement
Possible implant:
- Width: 15.5 cm
- Projection: 4.5 cm
- Volume: 650–750cc
Thin male wanting subtle enhancement:
- Width: 13 cm
- Projection: 2.5–3 cm
- Volume: 250–350cc
General Rule
The best pectoral implant size is:
- The largest implant that fits the chest naturally
- Without visible edges
- Without lateral overextension
- While preserving normal movement and contour
Dr. Barry Eppley
Plastic Surgeon