What Breast Procedure Would I Need to Achieve Desired Look? (photo)

I lost considerable volume in breasts after breast feeding, & would like to replenish the lost volume & re-fill the breasts. I decided on smooth round silicone sub-muscular implants. I'm 5'4" 115lbs 27yo. I want to fill the volume and achieve the look in the photo. I'm happy with my nipple placement & don't want to alter nipple position/shape. Please advise what procedure you feel is best. I posted this before, but am re-posting due to my reconsideration of the desired shape. Thank you!

Doctor Answers (30)

Expectations

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I think having a breast augment alone will give you the volume you desire but it may not give you the shape, you need to decide how much shape is of importance to you and if you are willing to trade shape for scars


New York Plastic Surgeon
5.0 out of 5 stars 39 reviews

What Breast Procedure Would I Need to Achieve Desired Look?

+1

Your nipples are low, but you say that does not bother you, and the photo you show of your desired breast shape is a woman with relatively low nipples.  However, you must realize that there are two purposes of a breast lift when performed in a patient who is undergoing breast augmentation...one is to lift the nipple, but the other and probably more important purpose is to lift a breast that is too far overhanging the fold beneath the breast.  Why is this important?  Because the bottom of the implant is at the level of this crease beneath the breast, and it "goes up from there", so implants cannot effectively "fill out" a breast that hangs too far below the implant.  The resulting breast will have the fullness of an implanted breast in the upper portion, and the deflated empty breast tissue can hang off of the implant and the nipple can be too far below the equator of the implant so that it points downward.  Careful examination and measurements by a plastic surgeon should be able to tell you whether you will be able to achieve an acceptable result (satisfactory breast contour even if the nipples are low), whether you definitely will not (breast hangs too low and will give you a "double bubble" unattractive contour), or whether you are right on the borderline and can consider augmentation alone, understanding that you may have to return for a breast lift later depending on your result.

Robert M. Grenley, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 70 reviews

Breast volume loss, implants, and breast lift

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It is unrealistic to expect a specific shape as seen in the photo of another individual. After surgery, they will still be your breasts, lifted and bigger.

Discuss specifically with your plastic surgeon, implant size, shape, position and possible need for a lift including were the incisions will be.

Good luck. I wish you well.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 37 reviews

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Lift or no lift?

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Breasts are as unique as your fingerprints.  Implants can improve the appearance and replace lost volume, but since each patients anatomy is distinctive, they most likely will not look like those in the photo.  From the photos you provided, it appears that you would benefit from a lift as well as an augmentation. Consult with a board certified plastic surgeon to see which procedures will help you achieve the best outcome.

 

George John Alexander, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Breast lift vs augmentation

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Breast lift moves the breast tissue superiorly including the nipple and areola (the pigmented tissue around the nipple) and leaves scars around the areola and skin underneath the breast. An augmentation adds volume to the breast without changing the position of the nipple. So if you are serious about being happy with the placement of your nipple, but not the volume of your breasts and were a patient of mine, I would recommend an augmentation without a lift--as long as you understand that the nipple position will not change. However, I have found for my patients that a submuscular implant with the location of your breast tissue will not give the appearance you desire as the implant will not be centered under the nipple but will appear too high with your tissue hanging off inferiorly. So I would recommend a subgladular implant, either saline or gel, your choice. I realize this is not the recommendation of many of my colleagues but it is what my patients and I have found works well for many of them. And if the appearance is too saggy after healing, then a lift can always be done later--often several years later. But each surgeon is experienced in different techniques so you need to talk with your board certified surgeon about what he or she feels most comfortable with  performing and will give you the results you want.

Margaret Skiles, MD
Sacramento Plastic Surgeon
3.5 out of 5 stars 10 reviews

Breast lift needed if significant sagging

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Thank you for providing the photos.  It appears from your photos that you need a lift in addition to augmentation.  If you look at your picture taken from the side, you can see that most of your breast tissue is below your breast crease.  The implant will sit above this crease.  Without a lift, the breast tissue will "hang"  off the implant.  The breast tissue needs to be lifted higher to give you the best result and achieve harmony between the implant and the breast tissue.  The nipple position should also be elevated but you can discuss with your plastic surgeon how high this should be.  Everyone has a different aesthetic sense and it is OK if you like your nipple a little lower.  My preference when doing a lift is to place the implants under the breast/on top of the muscle.  I also prefer silicone implants.  A thorough discussion with a board certified plastic surgeon will clarify things for you and help you make choices that are best for you.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
5.0 out of 5 stars 17 reviews

What breast procedure is needed to achieve optimum an optimum result?

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The best and exacting way of evaluating breasts is through actual physical examination. But after reviewing your phots it appears that yuo will need a breast lift and augmentation. Breast augmentation alone will leave the breasts hanging, and breast lifting alone will leave your breasts with lifted but leaving them flat. It iis quite possible that the lifting may be able to be performed via an incision only around the areola, therefore leaving minimal scarring. I think that if you really want to have optimal results you will need a combined lifting with augmentation.

George Lefkovits, MD
New York Plastic Surgeon
4.0 out of 5 stars 19 reviews

Procedures needed are a breast lift and augmentation

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It is very clear from your photos (thanks!) that the only way that you will be able to have your breasts rejuvenated appropriately would be with a breast lift and augmentation together. With the drooping present, a breast augmentation alone will not achieve a natural or desirable look. 

Steven Turkeltaub, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 20 reviews

Breast augmentation with or without a lift

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After review of your photographs and the picture of the desired result, my impression is that a breast augmentation combined with a breast lift will give you the optimal results.  You should understand that although breast lifts require additional incisions compared with augmentation alone, the breast skin tends to heal very well from incisions which generally fade quite nicely with time and the overall shape and position of your breasts will likely be more important ultimately.  As stated by some of the other surgeons, using larger implants to 'lift' the breasts often fails and leads to more breast skin and tissue stretching, therefore choosing the best procedure first is in your short and long term best interests.  Fat grafting as a component to your therapy can also be considered. 

Therefore, my  recommendation would be to have a breast lift and implants (silicone, partially submuscular ) for the optimal results with one operation.

Sean A. Simon, MD
Miami Plastic Surgeon
4.0 out of 5 stars 27 reviews

What Breast Procedure

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I think what you are really asking is can you just have a breast augmentation to achieve your goals.  From your pictures, it appears that you have a bit more sag than the woman in your "ideal" photo, though this is hard to determine since we don't have her preoperative photo.  From your photographs, I am concerned that you may have more sag than the "ideal patient" and/or that your breast shape will not be like the "ideal" if you just do an augmentation.  You can certainly have just the augmentation now, then decide on the lift later.  I have no doubt that you will need a lift at some point-either early if your shape is not acceptable, or later as your breast continue to sag, something that may worsen due to the weight of the implants.

Donald Griffin, MD
Nashville Plastic Surgeon
4.5 out of 5 stars 19 reviews

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.