I've had consults with 3 surgeons with 3 different recommendations. 339 mid range allergan 250 mentor moderate plus 350 high profile mentor all silicone. 12.5 bwd 115lbs 5'5"...will need a full anchor lift. Currently a 34A/32B. Told I will need at least 25cc of skin removed. 1st degree ptosis. Very little body fat. I want a natural look, and I prefer to err on the small side rather than the large. I am confused. Any recommendations?
Three Different Recommendations From 3 Surgeons. What Do You Think? 250cc Mod+ Versus 350cc HP
Doctor Answers (14)
Promoted Local Answer
Picking a size for breast augmentation.
It can be very confusing when three different surgeons give you three different opinions. Unfortunately, it's quite common because plastic surgery is just as much a form of art as it is a form of science.
As a general rule when my patients size their implants I like them to look at themselves with the actual implants in place in a testing bra. This is not a perfect teaching tool because implants can lose some projection particularly when placed under the muscle, but because we size with actual implants, to me it is the best teaching tool.
It is not uncommon in my own practice for patient to bring a friend or family member and a variety of different blouses and spend a good deal of time looking at the implants well before surgery.
So here's some basic thinking that may be of help to you:
When you look at implants on your frame don't just think about the size of the breast, but think about how it balances with the width of your shoulders as well as your hips. If an implant as to wide it will make you look top heavy, if an implant is too narrow it will look like a torpedo. In my own practice I try to focus on this relationship, and to me the width of the implant is almost more important than the volume itself.
Once you find the width of the implant that gives a nice overall balance with the hips then you can change the cup size by going high, moderate or low profile.
If you're agonizing between two sizes I generally recommend you go slightly larger, because it is very rare to hear patients say," I wish I had gone smaller".
Sometimes a patient who needs a breast lift is encouraged to go with a larger implant to to try and avoid the lift. I think that this is a mistake. I personally feel that it's better to get the size breast you want and let the lift happen if it's necessary.
Lastly, as a slender person it is always harder to have a more natural result. Patients with less breast tissue do not provide as much camouflage to help hide the implant. I always prefer a submuscular implant because it adds one more layer of tissue to help hide the implant from the outside world. In very slender patients I prefer silicone gel implants because they tend to look more natural as well. Even though you are slender, pick an implant that is wide enough to fill the chest appropriately. If you go too narrow, it can sometimes looked even less natural, smaller is not always more natural looking.
I hope these things that I've said are making sense, I hope I've been able to add some clarification in sizing for you. Best of luck with your upcoming surgery.
What size implants for a lift/aug.?
If you are getting a lift as well as an augmentation, given the info provided by you, I would go with the smallest of the implants recommended. This will not only look more natural, but should be more comfortable.
Breast Implant Sizing?
Thank you for the question.
Unfortunately, I do not think my opinion ( or that of other online consultants) will be precise enough to help you.
What I suggest instead is that you take the plastic surgeon who you feel will be most likely able to achieve your goals ( after doing your own due diligence). Make this decision carefully based on training, experience, and ability to achieve your goals.
Once you have made this decision, communicate your goals clearly with him/her. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
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I disagree with the full anchor lift part.
With the "full anchor lift," and implants at the same time there is a high risk for loss of nipple and the extensive scar is usually unnecessary. I would consider additional surgical consults if I were you, and go with the "lollipop lift," or vertical mastopexy with or without implant. This is a smaller scar and better lift for the majority of breasts. Whether or not you want 250 to 350 depends on the final size you want, and whether or not you use high profile implants or moderate plus implants depends on the width of your breast and the desired cleavage. Good luck. Dr. Smith
Breast implant size
You Should Decide On Implant Size
Since you have received three opinions differing as much as 100cc in their recommendations, you should decide on the most appropriate size for your wishes. I always approach patients this way (by having them try on different sizes of implants). In over 25 years, I have had very few patients who were unhappy with the size using this approach.
Lift with implants?
I never do implants with an Anchor Lift, because each operation interfers with the healing of the other. Have the lift first then try sizers on to choose the volume of the implants 3 months later. The profile of the imlants is decided by your measurements and I mean width. The width of the implants has to match the width of your breast/chest and the projection is chosen by you during the sizer try on. What's the mystery? Dr Foster
Recommendations for implants
Without an exam it is difficult to say what would be best for you. If you go to other surgeons you may get other opinions as well.
In general, if you are thin, you will like the feel of the silicone implant better than saline. And high profile looks more like surgery than nature so keep that in mind. As to size, no possible wayy to comment without an exam, it's a 3 dimensional decision. Even photos would not help much. But with grade 1 ptosis I'm not sure I would consider any type of lift. Photos would help with that.
Breast lift with implants
Breast augmentation with a lift is one of the more challenging procedures in plastic surgery. There is no way that you can decide on what profile or size of implant to use. You first need to find a Board Certified Plastic Surgeon that has experience with this procedure and look at photos of results. Then you need to convey to the surgeon what size of breast you are wanting. You can check out bra's at stores and look at patient photos. Once you have decided on the size of breast the surgeon will need to discuss the type of lift recommended. Once this has been all settled the surgeon will select the implant size and profile that will give you the result you are wanting and that fits your chest wall. To do this most experienced surgeons will use a temporary sizer in the operating room. Especially in a breast lift case I believe this is the only good way to do it. Trying on sizers on top of a sagging breast before surgery is a waste of time in my experience. After doing many hundreds of augmentation mastopexy procedures I have found the above technique to be very effective. I would also advise you to see at least 2 different surgeons as opinions can vary quite a bit on lifting techniques.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.