Dear Doctors, I am 22, 5'2", 100 lb, Asian lady with 32A going 32C. Please suggest implant style, placement, and incision to match my preferences: 1) as a martial art student, I do pushups and chest exercises (under-glandular placement?); 2) I would like to reduce the risk of problems with breast feeding in the future (inframammary incision?); 3) I like firm and perky look (how large should implants be and how much to overfill?) Thank you for your time and valuable advice!
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Doctor Answers 14
Given your preferences, I'd likely suggest a dual plane augmentation with an infra-mammary crease approach. In terms of size selection, I consider two factors when selecting implants for my patients:
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.
Lastly, please make sure your surgeon is board certified by the American Board of Plastic Surgery. The proper credentials and certification matters.
Hope this helps.
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Implant size and Cup size
At size 32 A, each 100 cc of implant will correspond to 1 cup size change. To go to a 32 C, you will need approximately a 200 cc implant. I prefer silicone gel implants because they feel and look the most natural. I also prefer implants placed in the retro-pectoral position since they have less capsular contractures and better stability. I would recommend inframammary incision since it is technically easier to do rather than the circumareola incision and you don't need a lift.
Gary Horndeski, M.D.
In my opinion, small women should have small implants. Large implants in a petite woman can stretch out and thin the breasts and cause real damage. They also look bad.
I'm glad you are considering the things you like to do now (exercise) and what you want to do in the future (be a mother).
Make sure your plastic surgeon measures you carefully and shows you some examples of similar patients. For patients like you, I usually recommend a gel implant under the muscle via an inframammary incision.
Don't go too big. You will regret it down the road.
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Ther are many options which would work well in your case. I would definitely place the implants u dee the muscle. It will not interfere with your physical activity. Either periareoar or inframammary incision would be fine. You should be able to recast feed in either case. I would leave the choice of incision entirely up to you. One of the other choices to make is saline versus silicone. I usually recommend saline, but there are pros and cons of each.Consult with a few surgeons and see which option you are most comfortable with.. Good luck!
Breast Implant Size
Thanks for all your questions. You are petite and the elements of your proportion need to be taken into account. An in person exam is required to determine exact dimension and the use of 3D imaging (Vectra) helps you see the actual results. If I were to guess a size for you it would be in the upper 200 early 300 CC moderate profile silicone gels. I still would recommend a subpectoral placement unless you are very concerned about the animation distortion. I do think an inframammary incision position is most appropriate. Whatever you do, stay away from high profile implants. They just don’t look good.
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With all your limitations your choices are great. as for size I might consider 350 to 400 cc HP implants.
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All your quesstions are excellent. However, an exam in person helps determine what approach and what implant choices are best for you. Good luck.
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While there is no "best" way to perform breast augmentation, your questions bring up some great points. First, In an athletic patient, it is probably best to use a subglandular position, but this probably has the tradeoff of higher capsular contracture rate (hardening).
Incision should not matter because it appears your areola may be large enough for an appropriate size implant to go through that approach, and if done correctly, you should still be able to breast feed. There are some studies showing nipple incision has higher risk of capsular contracture and infection, but it is often a better scar in the Asian patient.
Finally, if you are looking for a firmer look, the new Sientra (shaped gel) implants may solve this for you best. They are soft, firm, keep a perky but natural shape. The texturing may also help prevent capsule formation.
You sound like you are asking the right questions, now you need to work on finding a Board Certified Plastic Surgeon in your area who will discuss this with you in detail.
Three good questions about breast augmentation
Thanks for the questions - they are excellent things to consider and they show that you're being very responsible about your decisions.
I've done many subglandular and subpectoral implants on thin patients, both athletic and nonathletic. There are a number of things to consider, and ultimately no singular correct answer. The best decision will take into account how natural (how round vs how gentle-sloped) of an upper breast you are comfortable with having, and what your ideal size will be, compared to the looseness of your skin.
With regards to the incision, the IMF incision is a great choice given your anatomy and considerations. Regarding overfill, that depends on your implant type. Silicone implants are pre-filled, so the choices with silicone are shape and size, but not fill amount. With saline you can choose the fill amount, but most people would recommend against a saline implant above the muscle in a thin patient.
As you can see, there is a lot to consider, all of which and more will be covered during your consultation. Be sure to choose a board-certified plastic surgeon, and best of luck!
Every choice available to you involves some degree of trade-off. There is no "right" answer. Your best bet is to get opinions from experienced breast surgeons who will explain the trade-offs to you and allow you to make the choice that is right for you. I would avoid saline in any case as with your tiny frame and thin tissue ripples will be an issue! 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.