In short. The implant assessment establishes what your anatomy, tissue and expectations will allow before any device is chosen. Tape measurements set the limits; tissue thickness decides coverage; what you expect the implant to change decides whether the plan should proceed at all. A plan that survives those checks is auditable six months later.

Key points

  • Base width, pinch thickness, nipple position and chest-wall symmetry are tape measurements, written down.
  • Thin coverage means a smaller device, a muscle-covered plane, or edges possibly visible.
  • Most asymmetry is improved rather than equalised, and the plan should say which.
  • Nipple position at or below the fold decides whether a lift is part of the operation.
  • Weight history, smoking, medications, pregnancy plans and expectations all change the plan.

What does the tape measure, and what does it decide?

Breast base width, tissue pinch thickness, nipple position relative to the fold, and chest-wall symmetry. These are tape measurements, taken by hand, on you. They should be written down and you should be able to see the numbers, because they are the reason a particular device was chosen and they are also the reason a larger one was declined. A plan that rests on a photograph and a preference cannot be checked by anyone, including the surgeon, six months later.

The findings, and the plan for each

What is checked How it is recorded What it decides
Base width Tape, by hand, written down Which device is chosen, and why a larger one was declined
Pinch thickness Tape, by hand Coverage: a smaller device, more muscle over it, or edges possibly visible in some positions
Nipple position relative to the fold Tape, compared with the fold Whether a lift is part of this operation, staged later, or not needed
Chest-wall symmetry Tape, both sides Which breast is the reference for the plan
Asymmetry Written into the plan Corrected, improved or accepted; most asymmetry is improved rather than equalised
Pocket behaviour Written into the plan What happens if the implant sits high or the pocket does not settle
Your history Asked in the consultation Weight, pregnancy, medication, smoking and imaging findings, each of which changes the plan

Coverage is what the tissue thickness allows. Thin covering means a smaller device, a plane with more muscle over it, or an honest statement that the edges may be visible in some positions. Most asymmetry is improved rather than equalised, and that distinction belongs in the plan rather than in the conversation afterwards. Where the nipple sits at or below the fold, position decides the shape of the whole plan. Most pocket problems resolve with time, and the plan should say what happens in the minority that does not.

What should the assessment ask you?

The assessment is not one-directional. It should ask about your weight history, any planned pregnancy, your medications including anything that affects clotting, whether you smoke, and whether you have breast imaging. It should also ask what you expect the implant to do about the rest of your body, because that answer predicts satisfaction more reliably than any measurement on the list above.

Five questions worth asking out loud

  1. Which measurements did you take, and what were they?
  2. What will you do about the asymmetry?
  3. Is a lift part of this, or staged?
  4. Who performs the operation, and who follows me up?
  5. If I am not happy with the position at six months, what is the plan then?

A clinician who answers all five without hesitating is a clinician whose plan you can follow.

What does an unfinished assessment look like?

  • No numbers were written down, and the device was chosen from a photograph or a cup size.
  • Nothing was said about what happens if the pocket does not settle, or about the further operation most implant patients eventually have.
  • Your weight history, smoking, medications and pregnancy plans were never asked about, when each of them changes the plan.

You are not being difficult by working through this list in the room. A plan that survives the questions is a plan that was worth making.

The review at six months belongs in the plan

The plan should say what happens if the implant sits high, if the pocket does not settle, or if the shape is judged unsatisfactory at the review. Most of this resolves with time; the minority that does not should be a branch the plan already described, not something discovered at six months. The further operation most implant patients eventually have belongs in the same conversation.

Sources

Internal links

Frequently asked questions

Should the assessment include photographs?

Photographs are useful as a record and as a way of judging change over time, but they are not a measurement. A tape measures base width and pinch thickness; a photograph does not, and a photograph taken in different light flatters different things. Ask for the numbers, and ask for them written down.

What if the surgeon cannot tell me how the asymmetry will be handled?

Then the plan is not finished. Most asymmetry can be improved rather than equalised, and the honest version of the plan says which of the two is realistic for your chest. A plan that promises symmetry is describing something no operation delivers; one that says nothing at all about it has not addressed a finding it should have measured.

Is it reasonable to ask who will actually perform the operation?

It is one of the most reasonable questions you can ask. The assessment, the marking and the operation should be the responsibility of a named surgeon, and you are entitled to know whose hands are involved and who provides the follow-up. Asking does not offend a careful clinician; it is a question they expect.

Risks & Limitations

  • An implant is not a lifetime device. Exchange at some point over a lifetime is the planning assumption rather than a complication.
  • Gel implants are followed with periodic imaging because rupture can be silent.
  • The capsule that forms around every implant can tighten and change the shape of the breast.
  • A textured surface carries a small but real association with a treatable lymphoma of the capsule.
  • Sensation change, rippling, visible edges and asymmetry can occur. Scars are permanent, and no result can be guaranteed.

When to Seek Care

  • A breast that becomes swollen, hard, red or hot, or a new fluid collection around the implant — be assessed rather than wait.
  • A fever with spreading redness, warmth or discharge from a wound — seek care the same day.
  • A new breast lump, a change in the skin of the breast, or nipple discharge — assessed clinically without delay.
  • Chest pain, shortness of breath or a swollen painful calf — seek emergency care immediately.

References & Further Reading

  • American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
  • National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
  • Cochrane Library — systematic reviews
  • Chinese Medical Association Plastic Surgery Branch — clinical guidance

Medically reviewed by Tongchun Mao, MD (毛彤春), Deputy Director & Head of Aesthetic Surgery. Last reviewed: 19 September 2026.

This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.