Santa Monica Plastic Surgeons

Considering Breast Augmentation. Will 400cc Implants Get Me My Desired Look and a D Cup? (photo)

i am considering a breast augmentation, i am 5,6 i weigh 110 pounds and i want to go to a d, i was considering 400cc high profile implants or maybe even more, how many cc will i need to achieve this

Hello Ashton,

I am here to tell you that you are a disaster waiting to happen with a 400 cc implant.  You've got it all wrong (it's not your fault, your concept of breast augmentation is based on what most woman and many plastic surgeons will have you believe: that you can simply pick any cup size you want and get it, without any significant risk of complications).  Did you know that over 300,000 women had breast augmentation last year?  More importantly, did you also know that based on the most recent statistics submitted to the FDA that 25% of them will have an unplanned reoperation in 3 years due to complications, most of which are associated with improper implant size: capsular contracture, implant malposition, unpredicatable tissue stretch, severe rippling, symmastia, and double bubble.  Many of these problems are unpredicatable and occur in the 'best of hands', and if they occur are difficult or impossible to completely correct.

Unfortunately, there are all too many surgeons that will be willling to do that to you, so beware.  In the best case scenario with 400 cc implants, you will have a 100% risk of rippling within the first one to three months.  As time goes on (remember you and your implants will theoretically be together for a long time, right?), there is a high likelyhood untoward events will happen to your breasts.  Chances are stacked against you that you will need a second operation sooner than expected, putting you at a higher risk for a third operation.

By just looking at your photo of yourself, a properly sized implant will be closer to 200 than 400 cc.  However, by choosing this sized implant, you will decrease your risk of unplanned reoperation from 25% to 3%.  I hope you heed my advice and find a reputable surgeon certified by the American Board of Plastic Surgery and a member of the American Society for Aesthetic Plastic Surgery.

Best of luck!

Gerald Minniti, MD

Beverly Hills Plastic Surgeon

Will 220 CCs in the Fifth Generation Cohesive Implants Being Tested Produce an Adequate Result in an AA? (photo)

I'm currently scheduled to participate in the Allergan 410 clinical trial, receiving 5th generation Cohesive Gel implants next month. I'm 25, a 5'4.5, 110 pound, slender woman with little breast tissue to start, a 34AA. Because of my breast diameter, I'm limited to a 220gms/FF implant. I'm concerned this will only bring me to a small or mod. B cup. I'd like to be closer to a small C. The first two photos are of me, the second two of what I'd like to be. How far off am I? Thanks for responses!

Hello Kells9,

I think you have done very well for yourself finding a doctor that participates in the 410 study and is also recommending the most appropriated sized and profiled implant for you.  Contrary to most women and many surgeons, breast augmentation is not about getting whatever the woman desires in cup size.  That thinking has led to the current abysmal statistics regarding national complication and reoperation rates: 25% of the 300,000 woman having breast augmentations performed every year will have a second, unplanned reoperation within 3 years.

BTW, the photo of the woman labeled 'ideal 1' has at least one complication that is apparent: She has asymmetry due to unilateral malpostition of one of her implants, specifically drop out. This is most likely due to the unpredictable tissue stretch that occured with these oversized (for her anatomy) implants.  I don't mean to sound paternizing, but this is not what you want.  I bet she notices and has complained to her surgeon.

Heed your doctors advice! No, you will not be a C cup, but you will have a nice enhancement with little risk of either early or late term complications.

Best of luck!

Gerald Minniti, MD

Beverly Hills Plastic Surgeon

Which Breast Lifting Technique Would Be Most Suitable? (photo)

I have consulted a board certified PS & am in process of scheduling the surgery. Dr. has said for perkiest look go for a full lift w/ augmentation, and for a more natural look go with a donut lift w/ augmentation. Below are photos of the look I'm after & my own breasts. I know "perky" and "natural" have different definitions depending on each person. Which lifting would bring mine to the same position and shape? I know all breasts are different, I am simply going for that "style" in the pics

Hello Simona,

Although I've not performed an true examination on you, your photos suggest that your skin envelope lacks elasticity. Further, it appears that your inframammary fold is quiet a bit above you nipple, which means you have a significant amount of redundant skin that will need to be addressed.  This is never a good situation for the circumareolar mastopexy.  May I remind you that the circumareolar mastopexy is the number one procedure listed in malpractice lawsuits for plastic surgeons.  This is because it is all too frequently misapplied to people that aren't good candidates for the procedure. We as surgeons are all too willing to give what the patient desires, even if it is not what is right for them. 

If you look at my website, you will see many with the circumareolar lift, but NONE of them look like you prior to their surgery.  That is because that procedure is excellent for people with minimal sag of their breasts with good skin elasticity.  This is NOT about a minimal, 'natural' appearance versus a perky one.  This is about obtaining a shape that is natural with the finest scars possible.  Ironically, many people choose the circumareolar lift because of fear of scarring.  However, the circumareolar lift when misapplied yields conspicuous and potentially thickened scars in the wrong candidate.  In addition, the other problems associated with this lift in the wrong person includes: recurrent widening of the areola, non-circular areola, pleating around the areola, flattening of the breast mound, and persistent sagging of the breast mound below the inframammary fold.

I wanted to touch on two comments made by other surgeons. There is no evidence whatsoever that a 'Lejour' lift is any better than a standard form of a anchor lift.  In fact, there may be evidence to the contrary in the December issue of Plastic and Reconstructive Surgery.  In that article, photometric analysis of breast lifts gave objective results (not opinion) suggesting that a anchor lift gave the most lift to the bottow of the breast.  Finally, regarding placement of your implant, there is no evidence that a 'cold sub-fascial' placement of the implant is any different than subglandular placement, which is not a good option in a thin person like yourself.

I hope you make the right choice, and not one that makes you 'feel good'.  What I mean by that is if you are really adverse to the concept of scars on your breasts, maybe you should not do anything at all, rather than do the wrong thing. 

Best of luck!

Gerald Minniti, MD

Beverly Hills Plastic Surgeon