What type and size of breast implant should I get?

you have lost breast volume and have breast ptosis. Altough breast augmentation with breast implants will help to replenish your lost breast volume, you would also need a breast lift. Unfortunately, from your pictures, without an examination it is not possible to tell you what type of breast lift you will need.

Thanks for asking the questions. The photographs do show lack of breast tissue in upper pole and drooping of nipple areola complex. This condition will benefit from augmentation with implants and uplift of the nipple areola complex to achieve pleasing results. Based on expectation of perkiness and upper pole fullness, different implants can be tried as sizer to find the correct implant give the desired results. In such cases, implants are generally placed behind the muscle and implants might lose a degree of its projection. The implant selection should suit the frame and should be tailored to the patient to meet the expectations. The implants with softer gel, the ergonomics can be a good option for achieving natural look in the upper pole. Please see a plastic surgeon to discuss and look at all options for your surgery

Then you for posting with your photo and information. But you left out something I feel is most important.... the size you would like to be after surgery. A good guess would be around 300cc. An in-person evaluation with specific measurements and the use of sizers will help you decide on the perfect size.If you want them sitting higher and more symmetrical you will need to have a lift. The lift will help with symmetry.Best of luck!Dr. Miguel Mota.

With a single front image, it is challenging to be able to provide much advice. It is common in our practice to do a breast lift with an implant to provide the shape that patients are looking for. An implant alone might not really help you achieve the "perky" look that many people are thinking of as an end goal. It would be good to do a little research and find board certified plastic surgeons in your area with before and after photos, and who also have vectra 3d imaging software so you can see what different implant sizes would like like on your own frame.

It's difficult to say if you need a lift with your augmentation based on your photos. Your nipple position is on the border and your arms are elevated with raise them to some degree. So a consultation is necessary to give you more information. I hope that's helpful. 

I appreciate your question!

After performing hundreds of breast augmentations, I have found that the size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.

Silicone will give you fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured.

Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, is a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.

We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.

The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon 

#RealSelf100Surgeon

#RealSelfCORESurgeon

Hello and thank you for your question!  Your best course of action is to seek an in person consultation with a board certified plastic surgeon who can review options for you.  I hope this helps and best of luck to you! 

It is very difficult to tell from your picture if you need just a breast augmentation or if you also need a mastopexy. Deciding what procedure is right for you really depends on specific measurements. These measurements include the distance from your nipple to inframammary crease and the amount of skin stretch that you have. I always tell patients that the size of implant is determined by your chest wall dimensions not by what you want or the surgeons wants. By selecting the right size implant and wether you need just an augmentation or mastopexy should result in a well done procedure with excellent longevity. 
Good luck!! 

Hello and thank
you for your question and photograph. Without the benefit of examining you in person, and without a side/profile view of your breasts, it is difficult to answer your question.  However, with that said, the question of breast implants
alone vs implants plus a breast lift is a question I hear quite often, and
with a fairly simple answer.  Here it is...  If you want to
increase your breast volume and your nipple is below your breast crease,
you will benefit more from a breast lift, not just an implant.  Your breasts appear deflated, and both your nipples appear to be positioned below your
breast crease.  To increase volume and achieve a higher position, I would suggest a breast lift with an implant. In selecting the best
breast implant for you, I would base my decision on a number of factors:
(1)   Volume
of the implant
(2)   Contents
of the implant – saline vs silicone, saline tends to be a little stiffer,
rounder and can cause rippling of the skin
(3)   Shape
of the implant – round or anatomic
(4)   Position
of the implant – if it is over or under the pectoralis muscle; each location
would provide a different shape and projection
(5)   Skin
stretch of your breast – younger patients tend to have more taught skin with
more… SHOW MORE
resilience, and respond well to an implant; compared to an older breast with
more stretch marks, which would typically requiring a larger volume to fill the
breast
(6)   Degree
of breast ptosis (sagging) – a significant sag would also benefit from a breast lift, as in your case
(7)   Breast
diameter and overall chest circumference
(8)   Native
breast tissue volume – the amount and distribution of the natural breast
tissue.
(9)   Any
history of prior surgery or trauma to the breast
When looking for the right aesthetic plastic surgeon, be sure you clearly define your desired breast outcome goals and your surgeon addresses all your concerns and discusses
the surgery details including the position and size of the incision used, the
type of breast implants available, the risks and benefits of the procedure,
recovery time, and post-operative course.  Also, be sure to see plenty of
before-and-after pictures in real women (and not just computer simulations) who have a similar breast appearance to
yours, and preferably at different time frames (3 weeks out, 3 months out, etc)
to more accurately predict your own surgical outcome.
And lastly, I
think the most important component of the consultation is to establish a good
connection with your plastic surgeon.  It’s the connection that allows you
to clearly define your desired breast
outcome goals, the first step of this whole process. If you don’t feel you
have a good connection with your plastic surgeon after your consultation,
he/she may not be the best surgeon for you.Good luck.Mark K Markarian,
MD, MSPH
Harvard-trained Aesthetic Plastic Surgeon

Each woman's breasts have a unique size, shape, and appearance. When deciding on what type of implant to use or whether you need a lift or not it is important to have a thorough exam.  Factors such as height, weight, chest wall size, shoulder width, breast width, breast size, and amount of sagging are extremely important in deciding what will work best for you.  In my practice, several measurements are done to assess the dimensions of the breast and degree of sagging (ptosis) of the breasts. Many factors contribute to the appearance of your breasts: Age, Gravity, Pregnancies, breasts feeding, weight changes, and genetics.  It is normal to have volume loss after pregnancy with a lower nipple position, giving your breasts a "deflated" appearance.  Also most women have some asymmetry to their breasts in size, shape, or nipple size or position.  A breast augmentation can help restore the volume lost and give your breasts a fuller shape and appearance. Based on your photo you do have some degree of nipple ptosis (sagging) and areola size difference that can be corrected with a breast lift (or mastopexy). Most often women in my practice choose silicone implants for their augmentation because of the natural feel of the silicone implant but saline can also give you a nice result.  To determine the size of the implant to use, I encourage my patients to "try on" several sizes.  You can accomplish this by making your own set of implants. To make an implant: Take a knee high nylon stocking (not a plastic ziploc-that will give you square implants-not very attractive!), measure out in cc's or ml's with a measuring cup dry rice or oatmeal, start with 300 cc's and add or subtract by 25 cc's, twist tie the end and shape into a round "implant", place on top of your breast centered on the nipple in a non padded bra. Once you have your implants made, experiment with different sizes and different clothes (sweaters, dresses, tight shirts, etc) because they will look different depending on the thickness of the outfit. When you have the final size narrowed down, go back to your surgeons office and try on his/her implant sizers to finalize your choice.  I usually add about 25 cc to the final implant because it will look smaller underneath the muscle and breast tissue. I try not to choose the size for my patients but I am there for advice, opinion, and guidance. 

You appear to be a typical "borderline' case which can go either way with respect to your choice of breast enhancement procedure depending on your preference and expectation of your desired surgical outcome.

If you are prepared to accept your relative "low breasted" position on your chest and a reasonably sized breast implants in filling your deflated breast skin envelope post pregnancy, then I think you could achieve a very nice, natural, proportional result without any scars on your breast mounds. However, if you really desire for the "footprints" of your breasts to sit higher in your chest, then you'll require a lift and a moderate sized implants in order to allow the optimal tightening of your breast skin envelope and lifting of your breast & nipple areolar positions. A concurrent breast lift in addition to breast implants will also enable an appropriate proportional reshaping of your nipple areolar complex in achieving a more elegant and perky result with reference to your new breast dimensions and body frame configuration. The down sides of breast augmentation lift procedure would obviously involve additional scars on breast mounds, a more complex surgical procedure with more elaborate post op recovery and financial costs.

It's important to weigh all the clinical and logistics tradeoffs & limitations before deciding on the appropriate procedure that is right for you. I highly recommend you to seek a proper in person consultation with a thorough clinical assessment from a fully qualified specialist plastic surgeon for further in depth advice.

Hope that helps.

Best wishes

Ellis Choy