Christopher Hankins, MD

The determination of the right implant size for you is a decision that should be made between you and your surgeon. That being said, 600 cc implants are on the larger side of the spectrum of implant sizes and a large implant size is not necessary to take up the excess skin that is seen on your photos as a revision of the mastopexy would correct that.
Because I do not have the measurements of your breasts, I can only make an educated guess that in order to fit 600 mls within the base width of your breasts, you would require high profile implants.
Keep in mind that as a general rule of thumb, the greater the distance of the nipple areolar complex from the level of the chest wall, the greater the effect of gravity over time.

Thank you for your question. Selection of breast implant size should be a decision which is jointly made by both the patient and the surgeon. The patient should feel free to voice her preference for breast implant size while the surgeon can advise what implant sizes are appropriate for the patient, given the limitation of her tissue characteristics. I cannot comment further as there are no photos to examine. Keep in mind, that the larger the implant, that the greater the risk for tissue stretching with the passage of time. Hope that this helps.

Thank you for your question. Determination of implant size is an issue that should be determined with both the patient and the doctor participating in the decision-making process. The patient can voice her preference for her implant size and the doctor should then try to match the implant preference of the patient as much as her tissues will allow. One caveat that many patients do not realize is that in performing a lift or a mastopexy, there will be reduction of the breast envelope that is necessary to affect the lift that the patient seeks. The reduced breast envelope as a result will not accommodate as large as an implant as the breast would without a lift. if you have determined your implant preference, it would be well worth another visit with your surgeon prior to surgery to make sure that you all are on the same page as to how large of an implant can be placed while at the same time performing a lift or mastopexy. If the surgeon plans to bring sizers to the operation, you would need to know the range of sizers that were selected and that you would be happy with an implant of any of those sizes. Hope this helps and best of luck.

Thank you for your question. I looked at your photos very carefully and what I see is some hypertrophic change of the scars. In our practice, we have a post-surgical scar protocol involving the use of medical grade silicone gel, steroid injections and if necessary NdYAG 1064 laser treatments of the scar. If you are not happy with the scar I would strongly advise you return to your surgeon and ask for him or her to look at it. You mentioned that you had some holes and some bumps in the scar. This may be due to one or more sutures "spitting" in which they are recognized by the body as a foreign body and are expelled. These are usually not serious but sometimes can become inflamed. I would advise to have a low threshold to visit your surgeon so that any issues can be addressed while they are easily managed. Hope this helps.

Thank you for your question. I can address your question in general terms but it depends on two things: 1) what type of nursing job do you have? Do you have an administrative job or are you involved in lifting patients? 2) whether or not the breast implants are placed above or below the muscle. Many practitioners by default will place the implants beneath the muscle with the objective of minimizing the risk of capsular contracture of the breasts. However, it is quite safe to put that the implants in the submammary position with employment of the "no touch technique" of breast implantation. Avoidance of contamination of the breast implant minimizes the risk of capsular contracture. The only absolute indication for submuscular placements of the implants is that the breast tissue is too thin to camoflouge the upper pole of the implant. Submammary placement of the implants results in breasts that are more natural looking and avoids animation deformity.