Long Island Breast Implants doctors

Implant size is probably the greatest concern of patients seeking breast augmentation. Different surgeons have different philosophies as to selecting the proper size. I have been fairly vocal on this forum about this topic.

Selecting the proper size is one of the most important decisions you will make not in terms of being disappointed you went too small but in going too large and creating damage to your tissues and increasing the chance that you will need corrective surgery, increased downtime, increased pain and loss of sensation and other problems.

IMHO (I love that term), "trying on an implant" by putting it on top of your breast in a bra makes as much sense as trying on a pair of pants by placing it on top of your thighs. This practice takes absolutely no information about your breast tissue into consideration. If your breasts had the ability to stretch infinitely without sustaining damage, then that practice would work.

There are some who say that you cannot know the proper size implant ahead of time, but the fact is that you can. Using methods that take into consideration the base width of the breast, the tissue compliance (stretchiness) and tissue thickness, you can make a very accurate prediction of the implant required. I have been doing this for 8 years and rarely make a change in the operating room from my preop selection. I also get requests to change implant size far less that 1% of the time so the system clearly works. Using sizers in the operating room is not necessary in routine cases, however, I will state that they are very useful when the breasts are of differieng volumes and the use of two different implants is required.

As for placing the implant above the muscle, I havent done that on a primary augmentation in over ten years, as the dual plane technique as described by Tebbetts works wonders on a breast with some glandular ptosis (drooping) as seen in your photos. That is an entirely different discussion.

You need to see a surgeon well versed and experienced in this operation who can best guide you on what the proper implant size based upon yoru tissues is, and can also review with you the possible issues that may occur should you choose to use a different size. That knowledge only comes with lots of experience.

I think Dr. Aldea makes some really good points. You may have asked for these large implants, but the surgeon should also know and advise accordingly when the patient is asking for something unrealistic. He/she needs to be the patients advocate.

I know that not everyone shares in my opinions, maybe even the minority, but the fact is that if you appreciate the fact when you perform a breast augmentation you are placing a foreign body into a living structure, and the tissues thereof will change. The breast implant will not change. There will be stretching of the tissues and if the elastic capacities of the tissue are exceeded the tissue will lose elasticity like an old pair of underwear.

These issues have been well studied. If you exceed the recommended volumes for a given breast as determined by its dimensions and tissue characteristics, the downtime, pain, numbness, incidence of (or need for) revision and creation of potentially uncorrectable deformities will accelerate accordingly as well as losing any chance of a natural result. If this is important to a patient, and I know it is to my patients, then these issues need to be addressed and respected.

Just like nature has laws of physics such as the law of gravity (which we cannot change), nature has laws of tissue interaction. If you place a large implant into the breast, there will be forces created on the breast tissue due to the force of the implant stretching the breast tissue and the force of the implant upon the tissue due to its gravitational weight pulling the tissues downward. The first force will result in thinning of the breast tissue, loss of tissue elasticity and possibly chest wall deformities (ie from high and extra high profile implants) and the second will result in stretching of the tiisue envelope.

In your case, you are overweight (BMI = 32 in your case - >25 = overweight, > 30 = obese), had DD breasts (which are hardly small) and want to place super large (960cc) implants and want a full, high, fake look.

The problem is that placing implants will not change the quality of your tissues, and will not rise ot the top of the breast. In contradistinction, these implants will sit low on the breast, and then all this DD breast tissue that you have will sit in front of the implant and sag off of it just as it does now off the front of your chest wall.

The only options that I see for you are either to do nothing or undergo a breast reduction, which will, arguably, make you smaller but the breasts will be lifted. The upper pole fullness will be short lived as Dr. ALdea stated. A bra will be essential to help preserve your new look for as long as possible and to give you the look you want while supported in clothing.

I will make the assumption that your surgeon placed the implants under the pectoralis muscle. If he/she fit the implant to the pocket, then the most medial (inner) border of the pocket is where the muscle is attached to the breast bone (sternum). The space between these right and left attachments varies between individuals, so there is not much you can do about it. If you try to cut the muscle to bring the implants closer, then you will risk synmastia ("unibreast") and there will be very thin skin over the implant which may produce an uncorrectable condition called "window shading".

Your results look perfectly fine. As the breasts stretch (soften) they will be able to be moved closer together with certain types of clothing (HINT: I also would not recommend going any larger). You got a nice result. Quit while you are ahead!!