I Am Very Confused About What Implants to Get? 41, 5'5", 122LBS With Deflated C Cups? (photo)

I am 41, 5.5 and I am 122 pounds. I was always a slender woman with large breasts. I was a 34 DD, and have trained for competitions which brought me to a C cup. I have had two children. I feel like my breasts are deflated. I have researched implants, and have no idea if I should go with saline, silicone, over the muscle, under the muscle, where the scar should be, and now I am not sure if I need a lift. I don't want large breasts, but just enough to fill them up again.

Doctor Answers (17)

Implant size selection

+1

Thank you for your question.  I consider two factors when selecting implants for my patients:

1.Dimensional planning
2.Gel Implant Sizing system

Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.

Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look. Hope this helps.

Best wishes,

Dr. Basu


Houston Plastic Surgeon
4.5 out of 5 stars 115 reviews

Implant Selection Process

+1

Based on your photos, I would recommend a dual plane submuscular approach with silicone implants.   It would be important to have an in office exam and consultation to discuss the pros and cons of these approaches.  In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
5.0 out of 5 stars 35 reviews

Implants

+1

An examination is the best way to start. There are many options and combinations that are available to you and an open discussion with your surgeon is necessary

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 9 reviews

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I Am Very Confused About What Implants to Get?

+1

The best way to minimize (though not eliminate) the confusion is to have an in person evaluation, with and exam, and some give and take conversation about your goals, and how to accomplish them. 

For example, I don't know if you consider your breast to be too low. If not, you may not need to think about a lift (though again, I might think otherwise after examination). 

Most surgeons in the US use silicone, most prefer under the pectoral muscle placement. The silicone implants feel more natural. Under muscle placement usually looks more natural with the exception of the fact that they will be flattened some with pectoral muscle flexion. 

Trying on implants will help you and your surgeon select a size that works for you. 

When you are ready for an in person consultation, RealSelf has listings of surgeons in your area. You should consider cross referencing the listings from the The American Society of Plastic Surgeons (plasticsurgery dot org). A listing in the ASPS website assures you that your surgeon is not only board certified,  but also is a member in good standing of the major plastic surgery organization in the U. S. Thank you for your question, best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 30 reviews

Implant alone is usually not enough

+1

Many women focus on size, type of implant and position but a lift is more important.  Your photographs show your breasts are too low, you have no upper pole fullness and the breasts are deflated.  You would benefit from a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to reshape the breast tissue to increase upper pole fullness, increase your cleavage by moving the breast more medial and allow placement of the implants.  Aligning the areola, breast tissue and implant all high on the chest wall over the bony prominence will achieve maximum projection with a minimal size implant.  The best implants are silicone gel placed retro-pectoral since they look and feel more natural.  The smaller the implant the less complications you will have and the slower they will descend.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
5.0 out of 5 stars 123 reviews

Implants and position

+1

are always controversial issues as well as what to do for body builders.  These issues should be discussed with your chosen surgeon and it would probably beneficial to you to get a second opinion from a doctor that strongly prefers a different implant position.  And its always good to talk to your fellow body builders who have implants and get their opinions as to what is best.  The best implant is determined by your own desires and needs and is recommended after you are seen.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 16 reviews

Breast Implants in body builders

+1

On line advice can never replace an in person consultation, we can just give recommendations based on the information presented to us.  Let's look at your anatomy first; your breasts are equal in size, you have grade 1 ptosis, they are close together, there is a lack of upper pole fullness, your shoulders are equal and your nipples are on the same plane. You are a 41 y/o mother of 2 children with a very muscular body build and aspiring body builder?

Taking all these things into consideration I would recommend silicone implants on top of the muscle, around 400 cc with an incision hidden in the crease under your breast.  This will give you a quick recovery and I believe a STUNNING result!

Please consult with a board certified plastic surgeon or two or three, good luck!

David Finkle, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 45 reviews

Options for breast augmentation

+1

Hi there,

     Your nipple and most of your breast tissue is above your fold.  For these reasons, you do not need a lift.

     I strongly recommend silicone over saline implants.  The new gel silicone implants are absolutely safe.  They are superior to saline implant in all all respects.  The look more natural, feel more natural, and do not stretch the breast out as much as saline over time.  They also do not deflate.  Any tear on the implant surface is silent and may not be significant.

     I strongly recommend going behind the muscle.  The capsular contracture rate above he muscle is significantly higher than behind the muscle.

     For silicone implants there are three possible incision sites:  periareolar, inframammary, and transaxillary.  In my opinion, the transaxillary is least favorable as it limits some exposure and maneuvers that sometimes may be necessary.  Also, in the event of revisions, often they cannot be performed through the transaxillary incision and, theerfore, require a second incision.

     In choosing the implant size, I found that Mentor's VSS (volume sizing system) is extremely helpful.  Go to their web site LoveYourLook.com to learn about it

Good Luck,

Ary Krau MD FACS

 

Ary Krau, MD, FACS
Miami Plastic Surgeon
5.0 out of 5 stars 34 reviews

Breast implant options

+1

There are certainly many choices out there.  You need to educate yourself on the different options, the advantages and drawbacks of each.  Go on a few consults.  Different surgeons will give different opinions.  I prefer saline implants because there are fewer problems and concerns over the long term.  But there are many surgeons who will recommend silicone gel and will tell you they feel more natural.   As far as size is concerned, I recommend around 350 cc's.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 8 reviews

Best Breast Implant Size/Profile for Me?

+1

Thank you for the question and pictures. Despite providing good pictures and  precise body measurements, it is not possible to provide you with precise advice online.
 When it comes to selection of the “best” breast implant size/profile to meet patient's goals, the best online advice I can give to ladies who are considering breast augmentation surgery is:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.


2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural”  or “C cup” etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.



3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.
  





I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 707 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.