Ask a doctor

Rescheduled Surgery Due to Discomfort About Size? (photo)

Thank you all for your feedback. I went today for my surgery but was still not comfortable with the size after reading all of your expert comments. Instead I rescheduled for January 18th & plan to have 455cc. I'm hoping it will take me from a moderate B to a D. Any thoughts or feedback would be great. Again, I am 5'10" & 141 lbs (stress from this topic made me drop some pounds). Please let me know if this implant size, along with a crecentic lift would provide a small or large D cup? Thoughts??

Doctor Answers (13)

Crescent "lift" does not really lift! 455cc adds just under two cup sizes! Is this what you want?

+3

Cancelling surgery is a big deal, but if you're not sure, it was a smart move. You are tall, slim, and have at least grade 2 ptosis (might be borderline grade 3; only personal exam will tell). You don't have totally deflated breasts, but unless you are willing to accept the scars and cost of a breast lift (other than the totally worthless crescentic "lift"), your plan may still leave you with an unacceptable cosmetic result.

I agree with Drs. Schuster's and Nathan's comments about a crescent "lift." A crescent "lift" does not really lift any truly visible amount at all, and contributes almost nothing to skin tightening. Only the implant volume chosen actually "fills" your breast skin, and to achieve a full D-cup you may need implants in the 550-600cc range. Sure, they add a couple more ounces of weight to your breasts, which will gradually (continue to) sag over the years. But you can look good now without the scars and cost of a full or modified lift, and have more surgery down the road if you wish the perkiness a skin tightening operation (full or modified breast lift) can give you at that time.

Even if you choose implants only now and don't really achieve the look you like, you can always add the lift incisions and scars with a second operation. I only offer this option to patients after personal examination and full discussion of the pros and cons of somewhat larger augmentation only to more completely "fill" the loose skin, vs. lift plus augmentation. Some surgeons recommend this in two stages anyway (I peersonally do not), so this plan (if appropriate for your anatomy and wishes) preserves all your options while potentially minimizing your cost, incisions, and scars.

If your surgeon seems intent on simply "getting your surgery done" rather than giving you the best approach (or options) for your goals and anatomy (admittedly "borderline"), then seek another or two ABPS-certified plastic surgeons in your area for consultations and more input. Doing this right is smart! For examples of augmentation alone in a couple of my patients with moderate breast droop, click on the web reference below and look at cases 24 and 31. Best wishes! Dr. Tholen

 


Minneapolis Plastic Surgeon
5.0 out of 5 stars 123 reviews

Surgery

+1

You have a significant amount of ptosis volume loss and would benefit from properly sized/placed implants and a vertical/lollipop lift

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 11 reviews

Lift and implants

+1

A concentric or periareoalar lift will not give you enough lift.  also, in my opinion, you should not go as large as 455 cc's.  If you go with that plan, you will have droopy breasts with stretched out areolae.  Better to go with a full lift with smaller implants or a lollipop type lift.  Otherwise your nipples will end up too low.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 11 reviews

Implant Size Less of Issue Than Lift Technique

+1
Thank you for your question and photos. The implant size selection, while important is less of a issue with respect to your uneventful recovery.  You have a significant degree of skin excess and nipple ptosis.  While you can fill this out with a larger implant, the weight will eventually stretch the skin further.  You would benefit from a lift with your implants.  A crescent is unlikely to be effective in your situation.  A more formal lift such as a "lollipop" or "anchor" lift are probably more appropriate.  A formal exam would be needed to confirm this impression.  You should have further discussions with your surgeon about the lift.  Best wishes.

Robert F. Centeno, MD, FACS
Fairfax Plastic Surgeon
5.0 out of 5 stars 33 reviews

Best Breast Implant Size/Profile and Crescent Breast Lift for Me?

+1

Thank you for the question and pictures.

Generally speaking, patients are wise in postponing surgery until they feel as comfortable as possible that they and their plastic surgeon are “on the same page”. Preoperative communication is one of the major “keys”  to a successful outcome after breast surgery. In my practice, the use of goal pictures are instrumental during this communication process.

 Assuming you have chosen your plastic surgeon carefully and have communicated your goals carefully, I would suggest that you allow him/her to help guide you in the decision regarding best breast implant size/profile.  In my practice, this decision is often made during surgery (after the use of  temporary sizers).

 Also, be careful about the use of the “crescent” breast lift; this operation tends to be problematic in that it provides minimal to no breast lift and and can potentially distort the nipple/areola complexes.

 I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 722 reviews

Augmentation with crescent lift.

+1

I agree with the other physicians in that you would need an implant to give the volume and cup size you desire and that a crescent lift does little to lift the breast tissue, only deform the shape of the areola.

The vertical component of a lift is usually one of the best healing scars on the breast and will give you tremendously better results than a crescent lift. I also agree that if you were not confident in the treatment plan to postpone your surgery. 

Brian J. Lee, MD
Fort Wayne Plastic Surgeon
5.0 out of 5 stars 8 reviews

Need For Breast Lift And Implant Volume Change For Desired Result

+1

Given the deflational component to your breasts, I would question both the size of the implants you have chosen and the crescent lift. With your degree of breast ptosis, the crescent lift will have no significant lifting effect. Given the desire to avoid any more extensive breast scars, the crescent lift may be just a trial step toward the eventual need for a more formal breast lift. Placing breast implants will exaggerate the need for at least a vertical breast lift. To fill out the very loose breast skin that you have, it always take more implant volume than you think. It is good that you have rethought your surgery but I do not think you still have a plan that will not lead to a disappointing result.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 27 reviews

Escheduled Surgery Due to Discomfort About

+1

I applaud your decision! And I agree the need for a lifting. But if you are concerned with the vertical scar than have implants fist at 450 to 500 cc than heal. If still ptotoic than as a secondary operation have the lifting. Just another view or plan option. But I would do lift + implant in one operation. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Size after 455 cc implants and What Type of Lift?

+1

       I think you are on target with the size achieving your goals.  I would also say that you have a significant deflational component to your breasts.  The reason this is important is that depending upon how the breast augmentation is performed, you may not need a lift at all.  Once again, seeing you in person would give me a better idea.  The safe operation would be a vertical lift with breast augmentation.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 203 reviews

Lift and implants

+1

It looks like you would benefit from a lift possibly a vertical and along with implants. An exam in person would be essential.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 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.