I'm a DD Right Now and I'm Getting a Lift, Will 400 CC Be too Big? (Photo)
Doctor Answers 14
Breast Lift Surgery with a Small Implant to Increase Upper Breast Fullness
Breast augmentation performed in combination with breast lift is one of the most challenging surgical procedures performed by plastic surgeons. Although the results of this procedure can be dramatic, the procedure is associated with a high rate of revisional surgery. The procedure requires significant surgical skill and proper analysis of the patient’s anatomy and aesthetic goals. Because of this complexity, many surgeons prefer staging this procedure.
Your pictures and history suggest moderately large breasts with significant breast ptosis. Although, it’s hard to evaluate your breast volume without performing a physical exam, your pictures suggest the presence of adequate breast tissue.
Under these circumstances, several questions need to be answered. For instance, why do you want an implant? Is the answer to make your breasts larger or to provide increased upper breast fullness. If the answer is to provide upper breast fullness, this can certainly be accomplished with a much smaller implant. This would also lower the potential for complications.
If your primary concern is breast size then placement of an implant would definitely make your breasts larger, but most plastic surgeons would agree that this is a bad decision for a variety of reasons. Most surgeons agree that lifting the breasts often makes them look much larger than they did when they were saggy. This alone might address your concerns about size. In addition, the complication rate appears to be higher when larger implants are placed at the time of significant breast lifts. For this reason, most surgeons would avoid this combination when larger implants are used.
In your situation, it would be appropriate to undergo breast lift surgery with a small implant to increase upper breast fullness. Since you have severe breast sag an anchor type incision will probably be necessary.
It’s important that you consult a board certified plastic surgeon. This surgeon should be able to formulate an appropriate treatment plan.
The right choice of implants for you is difficult to suggest without an exam. You would also need a lift maybe a "lollipop" type of incision or a "T" closure.
Breast lift with implants
The number one cause for lawsuits against plastic surgeons is bad results for MASTOPEXY/AUGMENTATIONS. This operation can interfere with the blood supply to the nipple areola and lead to skin necrosis and death. The goal of the lift is to make the breast firm, lifted and therefore smaller. An implant makes the breast bigger! Well, you can't make the breast bigger and smaller at the same time, it is not clay, it is living tissue and the blood supply can be compromised. This can lead to permanently scarred and ugly breasts.
Your picture shows large ptotic breasts, I would recommend a Mastopexy or even a small breast reduction. Then, wait 3 months and re-evaluate, if you want implants have them place in a second procedure after you have completely healed. I think you will be pleasantly surprised, you have a lot of volume, when the droopy breast tissue is repositioned, it will look like you have breast implants!
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Breast lift without implants
I would strongly discourage you to have implants placed. One, you don't need them (you have plenty of breast tissue). Two, implants will only stretch out your tissues (regardless of where they are placed) and destroy your lift. So, if upper pole fullness is what you are looking for, then the Ultimate Breast Lift is ideal for you. This new technique reshapes and lifts your existing breast tissue and attaches it permanently to your chest to minimize downward migration. The results are firm and perky breasts. An added feature of this technique is that there is NO VERTICAL SCAR. This technique works for all breast types. Look into it. Best wishes, Dr. H
Breast Augmentation and Breastlifting?
Thank you for the question and pictures. You have brought up several issues which are worth discussing. In regards to breast implant size: the more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size. This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone and low/moderate/high profile), bra manufacturer variance in cup sizes, the degree of filling of the cup with breast tissue, and the subjective differences in patients perceptions of cup size. 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" or "top heavy" 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”.
In regards to breast augmentation and breast lifting surgery there is a difference in opinion you'll find among plastic surgeons regarding one stage or two-stage procedures. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.
The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.
In my opinion, the decision to do the operation in a single or two staged fashion becomes a judgment call made by a surgeon after direct examination of the patient. For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.
I hope this helps.
Breast Lift and implants--currently a DD cup
You apear to have an adequate amount of breast tissue, albeit droopy in shape. Unless you want to wear a larger cup size, i would reccommend a lift only. It may be possible to reshape the breasts and give you the fullnes superiorly where it is lacking without an implant. I think that breast implants are great, but they do have risks, and will most likely require replacement surgery down the road. Why add the additional risk if you don't want larger breasts, only perkier round ones. Good Luck
I'm a DD Right Now and I'm Getting a Lift, Will 400 CC Be too Big? (Photo)
I agree with your opinion. I recommend a 300 cc to 350 cc implant. Best to discuss your desires in detail with your chosen surgeon. Best of luck.
I'm a DD Right Now and I'm Getting a Lift, Will 400 CC Be too Big?
Hi fellow Canadian!
The combination of a breast lift and implant is a very challenging operation. Placement of the implant works against the lift: the larger the implant the greater the downward pull on the lift.
Moreover, the larger the implant the greater the surgical damage to the circulation of blood in the breast. This can cause healing problems with the lift.
I have found that patients are vastly more satisfied with their breast lift when they have even a small implant. This allows the surgeon to produce some upper fullness, something the lift cannot do (despite claims to the contrary).
Your surgeon will help you choose an implant size that will give you some upper pole fullness, without causing problems with the lift.
Implant sizing with a breast lift
If you are currently a DD and sagging, I would be extremely wary about putting in implants of any size. From your photo, it appears that you have adequate volume and all you need is a lift. Putting implants in will only go to causing recurrent sagging of the breasts very soon after your procedure.
Larger implants with a breast lift
The size of the implant chosen for a breast lift with upper fullness can depend on the size of the chest and the volume of the breast overall. Generally in order to make a difference in volume, a larger implant is needed in a larger breast. Still 400 cc is rather large and may push you into the DD-cup. Show your surgeon an example of how you wish to look.
Best of luck,
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