I need a breast lift and am concerned about the type of breast implant I should have. I am a full C and have laxity from weight loss. I only want to increase the cup size to a D but want the upper pole to be full and firm. I know that I will need by diameter measured first, but I wonder, what is the best implant type I should have to achieve a fuller upper pole?
Breast Implant Type with Lift for Upper Pole Fullness?
Doctor Answers (17)
The type of implant you cshould choose depends on the width of your breast
You should choose an implant which will give you enough width to achieve medial fullness or "cleavage". From what you describe, I would usually choose the moderate plus, given the fact that you don't want to be that much bigger and your breast, having been large is proably fairly wide. However I would caution you that maintaining upper pole fullness has more to do with how the dissection is performed, and thus you choosing the right surgeon, than choosing the right implant.
What is the best Breast implant type with lift for upper pole fullness?
There are two issues here.
The first is the type of implant to use for a lift. I have a preference for high profile implants because the higher projection of the implant helps pick up the slack of skin on the lower pole of the breast.
Whereas the diameter of the implant is important, I think POSITIONING of the implant is much more important.
Read my blog post link below, I have photos of 4 different patients with different implant positions relative to the chest. As you will see, implant position is crucial.
Breast lift and upper pole fullness
a good upper pole fulness can be achieved with a carefully designed breast lift alone. If you are interested in a very small increase in size, it may be possible to achieve that look and upper pole fullness with a lift alone. You may not need an implant at all.
If you however do need an increase in total volume with the help of an implant, then you want a round implant, not a shaped/anatomic implant which has more fullness on the bottom than on the top.
Martin Jugenburg, MD
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Breast implants for upper pole fullness
Patients have many options when considering breast implants and their use with a breast lift. A breast lift will benefit from an implant when it is necessary to add fullness to the upper portion of the breast or to improve the cleavage. Keep in mind that the weight of a breast implant may accelerate the process of breast and skin sagging and may predispose you a breast lift surgery in the future. For this reason, it is important not to use an overly large implant. For the surgery, it is possible to use a silicone or saline implant. However to improve the upper pole fullness and cleavage, a round implant would serve best.
Upper pole fullness created by surgeon, not by implant.
I know exactly the look you want, and I hope your surgeon does too. Upper pole fullness after breast lift with breast implants is achieved by how the surgeon does the surgery.
In New York City, we use round, smooth walled, moderate plus profile, cohesive silicone gel implants, but other implants can give you the look you want also.
Breast augmentation and upper pole fullness
This is an interesting question since you have lost some weight in the breast causing it to sag but it's still a C. Unfortunately, no matter how many people blog about this subject we could all be talking about a different thing. Your board certified plastic surgeon must evaluate you and see what his thoughts are on the lift with an implant.
Many times a lift will achieve the more youthful breast that you seek. It will not give you any change in your upper pole fullness though. The breast lift repositions the nipple and areolar complex and tightens the breast envelope so that it's once again somewhat more perky. I typically don't do breast augmentations on women with C cup breasts. It may be necessary for upper pole fullness but if your breasts are already sagging with their own weight and an implant is put in there, the result is fairly predictable. Sutures can tighten the breast for a nice lift at one stage and then the implant can be placed once the wounds have healed and the tissues are strong enought to tolerate an implant.
This is a controversial topic because many will simply put the implant in under your breast tissue then perform a lift of the skin and areola of your breast. Again, the only way to know for sure will be to consult with your plastic surgeon. Hopefully these concepts help you ask him more direct questions on his logic for the choices that you're considering.
Upper pole fullness and implants
You are correct that the base diameter is critical. The profile of the implant will determine how much fullness you get in the upper pole. Moderate looks the more natural, moderate plus has some extra push up look, and the high profile is the most dramatic potentially least natural look.
Upper pole fullness with lift/augmentation
As surgeons we like to show our best results and emphasize the positive aspects of procedures, but in fairness it is important we also tell patients what to expect in the long run. At first you probably will have good upper pole fullness, and maybe some firmness, but this will be short lived as the healing process proceeds. Within a year (may be less) you will notice decreasing upper pole fullness and firmness. Most women are still happy with the end results anyway. I find that in the consultation and even in post-op followup I emphasize to patients what to expect as healing and maturation of scars proceed. The closer a patient's expectations come to what can be achieved in reality, then the happier the patient is. When patients have unrealistic expectations, they are a set up for disappointment no matter how good the end results might be. Discuss this thoroughly with your physician and ask to see photos of patients that have had the procedure performed. Discuss the type of scars that will result as well as the immediate, mid term and long term expectations. It would not be unusual in years to come to slowly "droop" again and need a minor revision.
A breast implant and breast lift will never give you upper fullness
I have never been able to achieve - nor have I seen any other surgeon show long term photos of good upper pole fullness and firmness in any patient who has needed a lift/augmentation after significant weight loss. The skin is usually damaged and has lost its elasticity. Though early photos may show upper fullness, with time the lower breast stretches and the volume falls down and drops out of the upper pole. Sure, early results look good. But the larger and higher projecting the implant, the more the effect of gravity on the lax lower pole tissues.
My advice in general to such patients is to do the best possible lift. If and only if they need more volume, get an appropriately sized implant. And they should simply not expect to maintain long term upper fullness and firmness.
If any surgeon reading this post knows how to reliably create longstanding upper fullness and firmness in post-weight loss masto/aug patients, I'm all ears!
Implant type and implant choice.
Thank you for your question. Unfortunately, without an examination, it is difficult to give you the most accurate advice. Patient's in your situation present a difficult problem: you have sagging, loose skin from the weight loss, a nipple in a lower position, and a need for increased volume and fullness.
Combining breast lifts with implants can be challenging. Some surgeons will recommend a larger implant to try and "take in" the excess skin. The downside with this approach is the extra weight on an already loose skin envelope which can result in the implants bottoming out. You are correct in pointing out the importance of the breast width or base diameter. This is a good starting point to picking an appropriate implant. See the link below for help with picking an implant size. You should spend considerable time thinking about the volume you want to help you achieve what you envision as a D cup.
The projection of the implant (moderate, moderate plus, or high) will also have an affect on your result. Most women will do will with a moderate or moderate plus projection. The base width will help guide this choice. Care should be taken when choosing higher profile implants as they may add undue tension on the breast tissue which can accelerate tissue stretch and recurrent ptosis (sagging). Be sure to seek out a board certified plastic surgeon to have all your questions answered. Good luck!
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.