Leopoldo Baccaro, MD

I'm sorry you're unhappy with your result. You're right that the numbers are roughly comparable: breast tissue weighs close to 1 gram per cc, so 400 g removed is about 400 cc of volume. However, a 425 cc implant won't necessarily recreate your old breasts. Implants sit as a defined shape, usually behind or in front of the muscle, while natural breast tissue was spread out across your chest. After a reduction, your skin envelope is also smaller and tighter, which limits how large an implant can safely fit at once. Your surgeon will look at your chest width, skin stretch and current shape. Sometimes a slightly smaller implant, or a two-step approach, gives a more natural and safer result. Fat transfer can also add some volume. Bring photos of your breasts before the reduction to your consultation, as these are very helpful for planning. – Dr. Leopoldo Baccaro

It's smart to think about this ahead of time. The belly button scar can thicken or keloid in patients who are prone to it, just like the main incision. Surgeons can lower the risk with careful technique, such as minimal tension on the skin and shaping the belly button so the scar sits deep inside where it's less visible. If you form keloids, a prevention plan often includes: • Silicone gel or sheets once the incision has healed. • Close follow-up so any thickening is treated early. • Steroid injections into the scar if it starts to raise. At Naples Plastic Surgery we also have the UltraClear laser, which can help soften and flatten raised scars. We offer it at no extra cost to any of our post-surgery patients. Share your keloid history and any photos of past scars at your consultation so your surgeon can plan accordingly. – Dr. Leopoldo Baccaro

Yes, liposuction is commonly done together with a thigh lift. Removing extra fat first helps the skin drape better and lets your surgeon remove the loose skin more precisely. Varicose veins are usually treated separately by a vein specialist, often before body contouring surgery. It's worth having them evaluated, because significant vein disease can affect healing and swelling. Cellulite is improved somewhat by lifting the skin, but no surgery removes it completely. Recovery varies with the extent of surgery. Most patients go back to desk work in about 2 weeks and avoid strenuous exercise for about 6 weeks. Swelling in the legs can take a few months to fully settle, and compression garments help. An exam will show whether you need a short-scar or a longer thigh lift, and how much liposuction makes sense. – Dr. Leopoldo Baccaro

Your left breast implant has descended too low. It’s called “bottoming out”. You’d need a surgical revision to correct it. Good luck!

It all depends, really. You’re in a “gray area” where you could do a lift or not. It depends on your expectation for the outcome. If you want a smaller augmentation with “perky” breasts and cleavage… do a lift. If you’re ok going a little on the larger side to achieve a closer cleavage and upper pole volume… don’t do a lift. If you put a small implant in without a lift, they’ll sit too low and wide and you may not like that look. Hope this helps! Good luck!

Although it’s difficult to determine with pictures alone, there are several issues that would suggest it’s better to go a little wider. 1st - you already are wanting something slightly larger 2nd - you feel your chest is wider than 11cm. 3rd - you’re tall. Width also means height. If the implant is too narrow, it’ll also be too short. You’ll lose out on upper pole volume 4th - if the implants are too narrow, you’ll have a wide cleavage gap 5th - you have a small amount of ptosis (droopiness) at the bottom of the breasts. Your implants are going to tend to sit a little lower because of it. Which means you should tend to a wider base width. Hope this helps. Good luck!

There are a few important factors when selecting an implant. What’s the base width diameter (BWD)? What projection is most appropriate to achieve the desired results? What is the starting point? In your situation it appears you’re going for a natural look. Considering your starting point looks to be about an A cup, I’d recommend going with a high profile implant, instead of a moderate plus. The reason is because in your case, a moderate plus may look somewhat flat. I think you’ll still have a natural (or natural+) result. Each implant company is different, but the approximate equivalent of each company (for your circunstances) is as follows: Natrelle - Full profile Motiva - Full profile Mentor - High profile It looks like if your BWD is 10.5cm, you’re looking at an implant around 240-250cc, which isn’t very large at all. If you already like the look of a lesser profile implant, such as the moderate plus, picking an implant that fits your BWD should get you that look even though they are smaller implants. You’re more petite than women with larger BWD, so a smaller implant would look (proportionally) similar to those women. Hope this helps. Good luck.

When determining what size implant is most appropriate, there are a few considerations. Probably the most important is the diameter of the implant. You need a diameter that fits your chest correctly. The next important thing to determine is how much projection the implant has, or how tall the implant is. Wider and taller implants will give you more upper pole volume and more cleavage. This would be considered a more “fake” look, which some women prefer. Using an internal bra, and fat transfer, can also help you achieve your cleavage goals. This is what I’d call a “Hybrid BA”, which works very well.

Asymmetry of the breasts is extremely common. Although there are ways to improve symmetry, many times they come at the expense of scars. When it comes to droopiness of the breasts (called ptosis), there are some women who clearly do not need a lift, those that clearly need a lift, and those in between. Although difficult to say for sure, you seem to be in between. In these circumstances, adjusting for asymmetry could mean doing an augmentation with or without an implant. In general terms, is you use a smaller implant, it’ll be more difficult to get an aesthetic looking breast with a close cleavage. You can compensate for that by erring on using a larger implant. As for symmetry, it’ll depend how strongly you feel about it and the trade-off between having scars and symmetry. Hope this helps, good luck!

Slight breast asymmetry is common after breast augmentation. In your situation, it appears the left breast has settled a bit lower than the right. It looks like the right breast is "caught" by the muscle, which isn't allowing it to settle to a lower position. You can do massaging exercises to "push" the implant down into a lower position, however it likely wont be very effective at this point. I'd discuss with your surgeon in more detail. The best option would be a surgical revision, even though I know you're trying to avoid it. It would be a relatively quick procedure with very little downtime, so I'd definitely consider it.