I have two top choices for ps so far, but they are recommending drastically different approaches. Any other input would be helpful. PS # 1 recommends 800 cc under muscle saline. PS # 2 recommends lift with 500cc silicone or saline, my choice over muscle. What do you think?
Lift or No Lift? (photo)
Doctor Answers (17)
Smaller implants using simultaneous Mini Ultimate Breast Lift
You are in need of a lift. There is a new technique called The Mini Ultimate Breast Lift, which reshapes your breast to increase upper pole fullness, elevates them higher on the chest wall and more medial to increase cleavage. At the same time, an implant can be placed to correct asymmetry. Aligning the areola, breast tissue and implant high on the chest wall over the bony prominence will provide maximum anterior projection with a minimal size implant. Unfortunately, you have not told us your bra size but 800 cc implants would be too huge. The best implants are silicone gel placed retro-pectoral since they look and feel more natural. You are an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.
Gary Horndeski, M.D.
Lift and implant size
I would agree with the responses of Dr. Rand and Dr. Brundage.
Even a 500 cc implant may be too large to fit with the width of your breast. It definitely needs to be under the pectoralis muscle and a lift is required to raise the breast and reduce the areolar size. A too large implant works against this and larger implants do not lift the breast.
Lift or implant for saggy breasts
I agree with PS#2, the lift is needed to correct the sag, and the volume for the implant is probably correct at 500cc. But this depends on the profile and base measurement of the implant chosen as it relates to your chest measurements.
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Lift or No Lift
From your photos, you have droopy breasts (ptosis) so a Mastopexy with Augmentation would be recommended for the most optimal results. Silicone gel implants under the muscle would be my choice because they typically look and feel more natural but going above or under the muscle can be determined by you and your surgeon. Make sure you consult with a Board Certified Plastic Surgeon and do your research, possibly see one more so he/she can examine you and give you their recommendation. Best of luck!
Lift or No Lift? (photo)
I think you need a lift and an implant to get an optimal result. A large volume implant alone will not get you a good result.
Lift or No Lift? #breastimplants
I like choice number two. I never think it is a good idea to use volume of an implant to lift a breast. One has to identify the problem first. In your case form your pictures you have ptosis of the breasts. That is problem number one. To fix this you need a breast lift. That can be done with several techniques. The next problem you have to decide is whether you want larger breasts or not. If you do then you should have an implant appropriate for your breasts placed. An 800 cc implant, I would guess, is going to be way too wide for your chest. Without examining you it would be hard to tell. But, if larger, fuller, more uplifted breasts are what you desire, my snap shot opinion is an augmentation and mastopexy. Under or over the muscle is an entirely different discussion between you and your plastic surgeon, who you should make sure is board certified. Generally I like under the muscle for most patients, especially patients who need a breast lift and have thin skin and minimal breast tissue. That way the muscle will protect the implant. It also helps hold the implant in a higher position depending on how the much the muscle is released during surgery.
You have ptosis and your areola are wide. You need a lift plus some form of augmentation. I prefer submuscular augmentation but that is also dependant on your choice of implant
Lift or No Lift?
Lift, of course, the areola is to big, and take care with the volume, 800 cc is to much, and 500 cc over the muscle is to heavy for the skin.
Spanish translation provided by doctor:
Levantar, por supuesto, la areola es muy grande, tenga cuidado con el volumen, 800 cc es demasiado, y 500 cc sobre el musculo, es muy pesado para la piel.
Breast lift with or without implants
Based on the photographs submitted; it is my opinion, that you would be best served by having a mastopexy (breast lift) with or without implants. The mastopexy will result in perkier more youthful appearing breasts. If you also want fuller, larger breasts, an augmentation would be necessary. The nipple/areola complex will not be in the correct position with augmentation alone.
Treating the tuberous breast
You need to understand that you have a very tough starting point. Actually I don't agree with either surgeon entirely. The 800 cc augmentation without a lift will not look good. A 500 cc implant is fine as long as its base width is right for you. I would still go under the muscle and do a lift.