Choosing Breast Implant Profiles and Size for Deflated Breasts?

My breasts are deflated after nursing and I want to be informed for my consultations. I am 5'6", 150 lbs, have a 34-36 inch chest, roughly 13 BWD and want to fill out my breasts without going too big.

I describe it as wanting my money's worth and preferring the larger size of natural looking without looking obviously fake.

Based on my photos, what style of implant will work best (mod plus or high profile?), approx size (350cc-400cc, maybe bigger?) and does it seem like I need some kind of lift? Thanks.

Doctor Answers 19

Deflated Breasts Best Treated with SAM Breast Lift and Moderate Profile Plus Implants

Thank you for your question.

You will get the best result with a combination SAM (Simultaneous Augmentation Mastopexy) Breast Lift and Moderate Profile Plus Breast Implants. High Profile and Shaped Breast Implants will not give you as natural looking result.

Please see the blog in the link below

Natural appearing large implants

Unfortunately the most commonly used type of implants (high profile) and the most common type of placement ( submuscular/dual plane) cannot deliver the natural 'tear drop' effect that you desire.  There are also big problems associated with anatomic implants placed in conventional planes( they work well in subfascial carefully designed pockets).  This is why I use a very unique methof of breast augmentation that I call 'cold-subfascial augmantation.'  the placement of the implants is not 'above the muscle' or subglandular, nor is it submuscular or dual plane.  A very strong layer of connective tissue is meticulously and atraumatically dissected from the pectoralis major muscle and this tissue is used to shape and support a lower profile implant into a gentle tear drop shape.  It is the surgical dissection and not the implant itself that gives shape to the breasts.  The results sit like natural breasts and do not move like submuscular implants do with arm motion.  The fascia also supports the implant giving it relative protection from gravity and aging.

All the best,

Rian A. Maercks M.D.

Rian A. Maercks, MD
Miami Plastic Surgeon
5.0 out of 5 stars 47 reviews

Breast implant sizing

From your photos, you may need to have a breast lift as well as implants.   

Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.
3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  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” or “C cup” or "fake looking" 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.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.

Breast augmentation and lift

It looks like you will ned a lift and an augmentation. As for the berst sized implants, it is hard to say without a formal exam.

Steven Wallach, MD
New York Plastic Surgeon
4.5 out of 5 stars 21 reviews

Augmentation for a deflated breast

If you want the breast to sit higher up on the chest wall, and the nipple to be higher up you will need a lift. For that I would recommend a crescent lift mastopexy. You don't need any more scar than that, because you are adding a lot of volume that will fill up the slack skin. So the only skin you need to remove is that needed to reposition the nipple. The nipple stays attached, of course.

A high profile implant is indicated to add projection and lift the skin in the lower pole of the breast in practically every breast lift.

Check out the video and link below for more info.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 58 reviews

Deflated breasts can regain volume and shape with a lift and implant

Hello - It appears as though you're an excellent candidate for a lift combined with high profile 300-350cc implants. Performing an augmentation without a lift may cause the nipple-areola to "fall" over the implant. The recovery is very straightforward with minimal pain and downtime. Good luck!

Breast lift and augmentation

A side view would be better to get an idea of the amount of sagging you have, but it appears as if you will need some sort of a lift. With a lift, a surgeon can idealized your shape and form and then determine the appropriate size implant to use. He can probably use some tape to give you an idea of what the lift might look like and then perform measurements to get an idea of dimensions.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 10 reviews

Breast Implant considerations for deflated breasts

I agree, you need a lift with or without a small saline high profile implant. Go see 3 boarded plastic surgeons in your area to iscuss with them your options. Regards. 

Deciding on the best breast operation for you: Breast Lift and/or Implants

In agreement with my colleagues, I would recommend a lift to begin with. Although your existing tissues can be rearranged to minimize volume loss the upper half of the breast will not achieve fullness without the use of an implant. Some view this upper fullness as desireable whereas others believe it creates a "fake" look. That is a matter of opinion and you should express your desires to your Board Certified Plastic Surgeon who will review your options and help select the best implant that will accomplish your goals.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 58 reviews

Which breast implant would be best for me?

Hi there-

I definitely think you would be best off with a breast lift in conjunction with placement of implants...

With regard to the implant style and shape, it is very important to understand that the best implant for you should be determined based on your current examination and your tissues, and not simply based on your goals for size and shape. This is the "one right result" concept. For help understanding this and why it is so important, please read this:

One of the things I find most interesting is the amount of misinformation the average patient must sift through when researching breast augmentation surgery. In particular, I think that many patients become overwhelmed with implant choices and the abundance of information about these options available on the Web.

This is complicated once they contact a surgeon or two for information about the implants, and which is most likely to give them the result they desire. Somewhere along the way, opinions expressed by a surgeon are perceived as fact by a prospective patient (because of the surgeon's reputation or the apparent strength of his/her opinion), who then becomes more confused when she hears a differing opinion.

This leads to ridiculously technical questions being posted on sites like RealSelf and others, such as:

"I am 5'5", 125 lbs, my measurements are 34, 22, 36. I have had 3 babies, all by C-section, and I breast fed two of them. My breasts sag a little, but not as much as some women I have seen. I want to have a full C-cup breast. Should I get 325 cc Allergan 410 style implants, or Mentor 350 cc Moderate profile implants. Projection is more important to me than a natural shape..."

Every time I get one of these over-thought questions, I always think the same thing... ???????

Let's take a big step back from the trees here and take a look at the forrest in front of us, shall we?

Fundamentally, the reason any woman seeks breast augmentation is because she wants to achieve a certain appearance, right? Let's repeat that- to achieve a certain appearance. NOT a certain bra size, or a certain implant volume, or even a certain implant type. When you first stared to think you might want an augmentation, you didn't think, "I would like it if I could have 350cc implants"... You probably thought, "I would love to look like that (after admiring another woman's breasts)..."

So if we can agree that what you are really after is an appearance you would be happier with (as I always tell my patients), let's make the desired appearance the focus of our communications...Let us both ignore bra sizes (which are not standardized and the choice of which is very arbitrary) and implant types/sizes (for now)... Let's first understand what you want to look like. I think you would agree that if we are able to make you look the way you wanted to look, the letter on your bra and the number on your implant is lees important, right? Help me understand what you want to look like, and I can give you a very accurate recommendation of options for achieving that appearance -- provided a careful physical examination has also occurred.

Why is the exam so critical? After all, can't we just put small implants in women who want small breasts and larger implants into those who want larger ones?

The exam is critical, because for any one particular woman, there are only a few good choices of implants available, regardless of her goals, and these options are arrived at by taking careful stock of her breast tissue, skin, and frame. In other words, your anatomy will, to a large extent, help us understand the implant options that would make you look the best. This is the "One Right Result" concept. The taking of these measurements is so important, I do it myself every time, and based on these measurements and my patient's goals, then make recommendations regarding the implant options available to her (as these options would be different for different women).

While (as with any aesthetic procedure) no guarantee of outcome can be given, you are much more likely to achieve your desired outcome if you focus on communicating your desired appearance successfully with a skilled and experienced, Board Certified Plastic Surgeon than by over-researching the implants and micro-managing the details of the surgery. In fact, I can think of no better way for you to increase the odds of you ending up dissatisfied.

So don't over-think it. Think carefully about the appearance you want, communicate it carefully to your surgeon (using photos if possible), and make sure that the implant choice arrived at by the two of you together is based on both your anatomy and your goal. You'll be happier and the process will be less stressful!

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.