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CLAIM YOUR PROFILEYou have nice breast shape and modest to full size. Your breast seem to nicely match your new body after the weight loss. How much larger do you need to be to be happy? If you have an augmentation now, you would need at least a limited (peri-areolar mastopexy) to raise the nipple areolar level an inch or so. If not your nipple and areola will look droopy on top of implants that are under the muscle. You do have the option for a subglandular (not submuscular augmentation) but you need to know the long term issues (mammogram quality, capsule formation, and pressure breast atrophy).
If you are thinking of having kids within a couple years, you should really consider NOT doing any surgery now and waiting to after kids and breast feeding. The is virtually a 100% chance you will want a revision after having kids. The breast get large, then skin stretches and then you can loose breast volume after pregnancy. Please consider waiting and learn what you options are for care.
Fat grafting for small to modest size increases is a very good option for you. There is a potential for increased natural breast size, improved shape, no lift and some permanence that will last forever even after having kids.
David S. Goldberg, MD
Board Certified Plastic Surgeon
You look very symmetrical. Excellent. The nipple position is well within the norm. You should understand the our bodies to change and age with time. You can always do some procedure to change the way you look but often it's not worth the time, effort or cost.
As far as breast are concerned you should now how to do a quality self breast exam. When you are 40 you can get mammograms unless you have a family history of breast disease. In that case your doctor may recommend earlier screening with ultrasound or mammogram.
Breast implants are NOT lifetime implantable devices. Virtually all patients will want or need a change or replacement at some point.
Board Certified Plastic Surgeon
Your surgeon did a very good job. Your folds were asymmetrical before surgery and he help to improve your IMF. Your shape is quite nice.
What are you not happy about?
Dr. Goldberg
Board Certified Plastic Surgeon
All scars take time to heal. The incisions can look worse at 2 months then just after surgery. That is because of the way our incisions (wounds) heal. Collagen formation in a mature scar is about time. It will take a year as you have been through it before. Your skin may just not have the elasticity it once did. There is some evidence that placement of autologous fat (your own fat) under the skin of the breast or other scars can help improve the elastin and collagen of the skin. Of course, this potentially means another operative procedure, but gaining the upper pole fullness and improving skin elasticity will be worth it.
DG
Board Certified Plastic Surgeon
You have very nice breast shape now. you have nice skin and should scar fine with a mastopexy. If your implants are 400cc, chances are (based on your photos) that you have adequate breast tissue to have a full B or small C cup breast without implants. However, you will need the full anchor incisions to give you the best result you will want. The distance from your clavicle to the inframammary fold is very long on your chest. In order to improve the flattening of your upper chest after implant removal, as much as your remaining breast tissue as possible will need to be lifted towards the upper chest. Breast feeding depends on keeping the breast ducts intact and should be fine after a mastopexy. There are board certified plastic surgeons in Seoul, S.K. Check the International Society of Plastic Surgeons web site or the American Society of Plastic Surgery and look for a certified surgeon in your area. Ask to meet patients, ask to see their incisions. Meet the office staff. Ask lots of question like " How many mastopexy procedures have you done? ". That is more important then seeing photos....
Regards.
DG.,
Board Certified Plastic Surgeon
The side view is best for determining nipple position, lower breast skin position to IMF (inframammary fold) and degree of droopiness. However from your one photo we can tell you have very nice shape and minimal ptosis. There is an increasing trend for placing implants under the gland again and not under the muscle. You certainly would not need a lift if the implant is place in the subglandular position. However, some studies would indicate you have a higher risk for capsule formation with subglandular implants and mammogram detection is easier with pectoral implants. If you want your implants under the muscle then a limited mastopexy is probably indicated. That being said, the most important measurement for determining implant size is the base width of your breast. Rest your hand on your head turn to the side the and you can see the true breast width. If it's 12 cm then we could pick a 12 cm wide implant that is low profile for small augmentation, medium profile for larger augmentation, etc. No surgeon can truly predict cup size as bra sizes are not standardized. Now you do have alternatives including autologous fat grafting to the breast if you are really seeking limited size increases and are willing to be patient with results. The benefit of fat grafting is that it's your own fat! The limitations of autologous fat grafting is generally limited (1/4- 1/2) cup size increase with each treatment and some risks of volume atropy if the grafts absorb. There are some surgical risks of Fat Grafting, but when done by a qualified board certified plastic surgeon your results should be very nice.
Your shape is very good now. Your may want to consider options of Fat Grafting as the incisions are tiny, the risks are very low and there are No implants to worry about going forward. All natural.
DGDGMD
Board Certified Plastic Surgeon
My impression is your breast size is plenty full enough to offer a very nice result with a mastopexy only. Why get implants if you don't need them? I almost never remove tissue simply to add an implant. A well performed modern mastopexy will comprehensively lift the breast and remove skin. Yes, you would need the traditional yet limited anchor incisions (periareolar, vertical and inframammary) . Are you generally happy with your breast size in a tight bra? Why do you need to be bigger? What truly are your goals. A well performed lift will give you a more youthful look without all the long term issues related to implants (risk of capsules, 100% lifetime need for revisions, cost). Your issue is ptosis (droopiness) breast, not small breasts. Dr. DGDG
Board Certified Plastic Surgeon
Be cautious choosing non invasive or non surgical treatments for treating loose skin. If you have jowl, and loose skin of the neck then a face lift is the most effective treatment. You seem to have nice skin and you have a very nice long vertical neckline. In my opinion, treatments such as liposuction only, or laser type procedures will not effectively tighten the loose skin enough to deliver long lasting results. A face lift can safely and effectively be completed in either an office setting or outpatient surgery clinic. Make sure your surgeon is board certified (ABPS) and ask to chat with their other patients who underwent a similar operation. Surgery is not without risk, however a well done face lift is really primarily skin surgery (with a little muscle tightening also) that will give you wonderful long lasting results. The risks are low when your surgeon is skilled and the support team and facility are well equipped, and experienced at doing face lifts.
Board Certified Plastic Surgeon
It is not possible to tell by the photo. I agree that you should see your surgeon. The breast augmentation incision often has a few layers. Superficial skin is separation often can be treated as a wound problem. However, if a deeper process is going on then it needs to be addressed soon. Implant infection may require re-operation and implant removal. Don't delay. If you are sending a photo to your surgeon, then take one in much better light.
Board Certified Plastic Surgeon
I agree with removing the piercing. The nipple ring is a foreign body which can increase bacteria and risk for infection in the areola. The scars may heal just fine with time. In very pigmented or black skin color, the scars and skin may be more prone to noticeable scars. Time will help. I would recommend upwards of a year before considering surgical revision. Consider silicone patching or steroids if a keloid type scar forms (which is unlikely).
Board Certified Plastic Surgeon
Dr. Goldberg did my breast augmentation and 6 years later I hired him again to remove them. He is a talented man and does a very good job with aesthetics. I do feel my implants were too big for my frame. The pockets that were cut to fit the large implants are still an issue. I’m not sure if they will ever heal completely. I liked my breasts with the implants but I was having health issues and wanted them out. He obliged, and was neither particularly supportive nor discouraging. Since having them removed 16 months ago my health has steadily improved. I feel like he got most of the scar tissue out, although I still have somedenting and fibrous spots. I would have appreciated a bit more of a lift as well (he said he would do a small one). Overall Dr. G is a great surgeon who wants to meet the expectations of his clients. I would recommend him based on his attention to detail, pleasant personality and willingness to accommodate requests. Don’t come here looking for that gem of a plastic surgeon who believes you when you say silicone implants have adversely effected your health. He won’t wrap his head around it, and he’s definitely not alone. There are several in the US who get it (Dr. Feng is one) but I chose him again based on my own comfort level and trusting him to make sure I would still look good. I deducted a star because his areola work could be more precise. Mine needed a revision which I never did get. Also, I had the infamous “double bubble” when I bent over or flexed. I included a photo of this which was taken from the floor as I leaned over the camera. I believe this happens a lot when the implants are too big for the recipient. I’m so happy to have them out. I feel healthier, more youthful and I notice I am able to detox and stay healthy a lot easier. I think implants will be going out of style. Fat transfer is amazing. Check it out if you’re considering implants. Google BII or search the many groups online if you’re curious.
I've always hated my turkey neck .. I researched lipo and kabella decided to do lipo after reading so many horrible stories on kabella . I interviewed 3 different doctors And decided on Dr.Goldberg he did a wonderful job it's only been a few day and the results are awesome . I should have done this years ago !!!
Dr. Goldberg is by far the best plastic surgeon ever!!!! I saved for a few years to pay for my surgeries but knew the outcome would be worth the wait. I put all my trust in dr. Goldberg & couldn't be happier with the outcome. His staff connie and jen are soooo helpful and sweet they treat u like family. Updated on 25 Oct 2015: Will post pictures soon preop and post op and keep everyone posted ....BUT SO FAR SO GOOD.....NO COMPLICATIONS AND RECOVERY IS GOING WELL. THANKS TO DR . GOLDBERG AND CONNIE AND JEN'S ADVICE ????
I strength train, yoga, hike, spin and eat clean. I'm in shape, however, I'm not happy with the loose skin and fat on my belly. I'm ready for it to be gone! My surgery date is June 26th. I will have a tummy tuck, muscle repair and some lipo. Dr. Goldberg is the best in the area and I can't wait to see my results. Will post pics soon! Updated on 16 Jun 2014: Tomorrow is my pre-op appointment. I'm 9 days away from surgery. I snapped this photo tonight while shopping at the Victoria's Secret semi-annual sale. Didn't buy too much because I want to wait and see how clothes fit with my new shape. :-) Updated on 17 Jun 2014: I had my pre-op appt this morning. I signed a bunch of scary paperwork (you know, the paperwork about all the risks of surgery). The nurse went over my list of meds and when I need to take them. Now I just sit and wait for the hospital to call with my surgery time. 8 more days.... Updated on 26 Jun 2014: It's over! I survived. :-) I arrived at the hospital this morning at 6:15 and surgery was at 7:30 am. I came home with a catheter, pain pump and drain. I'm not in pain, just uncomfortable. Will update more later when I'm not so sleepy. Updated on 26 Jun 2014: Here's my first pic from post surgery. Updated on 27 Jun 2014: Nurse stopped by my house to change out gauze, refill my pain pump and took out catheter. I got to see my new tummy today. Scar is a little longer than what I expected, but I'm sure it'll look great once it fades. Updated on 28 Jun 2014: Yesterday evening was a little rough. Today has been much better. My friend spent the day with me watching movies. My husband washed my hair tonight and that made me feel 100% better! :-) I still have my pain pump and drain in. I'm taking my pain medicine (Norco) every 5-6 hours. I'm not draining out very much. My doc said it's because he used a lot of stitches. He called today to check on me and I see him in the morning at his office. Updated on 29 Jun 2014: It's Sunday and my doctor had me visit his office. He took my 2 stitches out and refilled my pain pump. I'm still very swollen. Feeling a little better each day! My pain pump and drain come out in 3 days. Updated on 1 Jul 2014: Tonight is my last night with my drain and pain pump. Yay! I will feel more normal once they are gone. I've noticed the swelling has gone down a little in my abdomen. Updated on 2 Jul 2014: I feel more normal now that my pain pump and drain are gone. YAY! I woke up this morning feeling my best since my surgery. I'm taking it day by day! :-) Updated on 3 Jul 2014: I've made it to my first week post-op! Feeling pretty good other than being swollen and sore. I see my doctor again on Monday. Happy 4th of July weekend to everyone! :-) Updated on 5 Jul 2014: It's 2:30 am and I can't sleep! My right side/hip is itching like CRAZY! Anyone else experience this? I'm so miserable. Updated on 6 Jul 2014: Left side of pic was day 3 and right side is day 10. I felt AMAZING today. I have an ant infestation in my kitchen. I cleaned out my pantry (with my daughter's help). Maybe a little too much for me to do just yet. I was very careful, but can feel the swelling increase. :-/ Updated on 9 Jul 2014: Left pic week 1 and right pic is week 2. I'm starting to see results as swelling is gradually decreasing. Soooo exciting!! I saw my doc on Monday. I had a little fluid buildup that he had to drain. He says I'm looking great! I can now get my incision wet. Last night was my first real shower and it felt AMAZING! I didn't want to get out. I'm starting to put aquaphor on my incision. I see my doc again next Monday. Hoping I can start scar therapy soon! Happy healing, everyone! :-) Updated on 10 Jul 2014: 2 weeks since surgery. Time has flown by! I'm starting to do a little more and more each day. It causes me to swell by evening. Dang! :-/ Updated on 17 Jul 2014: I'm feeling better and better each day. I went grocery shopping for the first time the other day and it wore me out! I'm still taking it easy. I see my PS on Monday. Hoping to start scar therapy this week and I should be cleared to exercise next week. Updated on 21 Jul 2014: I saw my PS this morning. He cleared me for exercising. I'm looking good. He took pics today of front and sides. Didn't discuss scar therapy with me. He did mention that he would be lasering the scar at 6 months post-op. I've been seeing him weekly, but I will see him again in 4 weeks (unless I'm having any problems). Will post new pics tonight. Updated on 24 Jul 2014: Wow! I can't believe my surgery was a month ago. It's been an amazing journey. It's neat seeing my transformation from week to week. I'm adding a bikini pic of me before surgery and a bikini pic now. I have so much more energy. I'm back to grocery shopping, laundry, sweeping, all housework! I still take it easy and my body lets me know if I need a break. I leave for Disneyland in a few days so hoping I can handle all the walking and excitement! :-)
Glad I did it! Just wish I saw this site before I had my procedure. E down to a c and very happy about it! I am here to look for information on proper care after the surgery and what other people have done to help scaring and or reducing it. Im looking for anyone who knows about ointments or creams that will work
I've considered a "mommy makeover" for years after my two children. I have always had smaller breasts, but pregnancy, nursing and weight loss have left my breasts deflated and small. Up until now, I have been unsure about surgery because of the costs, recovery, scarring, etc. I have never had surgery, so I have decided to start with the augment. Many people I have talked to told me that the augment may make me not as interested in the tummy tuck since my stomach is not that bad. And I am nervous as to how I will take recovery. If all goes well, I can always do the tuck later. I have done a significant amount of research, and while I'm still nervous I have taken the plunge. I am one of those people that once I make up my mind, I have to do it right away. Timing is perfect due to my job, so it was now or never. I scheduled my appointment this week for next thursday!!!! I am so nervous and excited. I am 5'8" and 142 pounds. The doctor has recommended that I have a periareolar mastopexy with the augment due to slight ptosis. He wants to do a crescent lift, which after doing a lot of reading I am very nervous about due to the potential for bad results. I have heard great things about this doctor, so I want to trust his opinion, but research has made me very nervous. We have decided that he will be ordering three sizes of implants and he will make the final call during surgery. I am good with that portion because I have read that a lot of people wish they would have gone bigger. He is known for being conservative, and with my height and shoulder width can carry a little more. So he is ordering mentor silicone 450cc,475cc and 500cc. I am slightly worried that I will be shocked at the size, but do not want to wish for bigger after and both doctors recommended this size, so I am ok with that. The only part that makes me nervous is the lift portion. He doesn't believe I need the full lollipop to get the results, especially with the larger implants, but I do not want to hate my nipple after all is said and done. I just received the go ahead from work yesterday and they were holding the slot for me unofficially for next Thursday. I told them its a go for the 18th, and now it is all becoming so real. I just asked them last Monday, so I had my final appt with the doctor thursday, and have my pre-op on Tuesday. They are having me start Arnica Montana a few days out to reduce swelling and bruising, and I am in a mad panic trying to find comfortable clothes. I am unsure as to what all to have available afterwords in regards to clothing. But bought two bandos from Victoria Secrets and am heading out this weekend to buy zip up sports bras. But I have NO idea what size to buy, so its all a guessing game. Any help is greatly appreciated. So that is where I am now, and I will do my best to update. Very excited, yet very nervous!!! Updated on 17 Oct 2012: Wow...tomorrow is the day!!! I am so nervous and excited at the same time. This happened so fast, after years of considering it, and one year of actually considering it, I made the final decision 2 weeks ago, and scheduled the surgery last week. Now I'm down to the last day of having my "birth boobs"....it is a strange feeling. I stood in the mirror this morning taking a hard look at what I have, since it will be close to the last time I see what I've seen for so long. The doc gave me some valium to take tonight to relieve anxiety, which I think for sure I will need. SOO EXCITED BUT SOO NERVOUS!! Updated on 18 Oct 2012: The day is here! I met with the doc yesterday to go over last minute concerns and he made me sooo much more comfortable about everything! I really love his honesty and frankness, for me that puts me at ease. So I'm still nervous because of never having surgery before but I'm ok. It doesn't seem real that in a few hours I will have two new friends!!! Updated on 18 Oct 2012: Well, I DID IT! I've spent the majority of today sleeping. I got to the hospital at 0630 for a 0730 surgery. Everyone was so good and helpful. The surgery took the full 3 hours and I ended up staying a little longer because my body didn't like general anesthesia too much. Took me a while to fully wake up and not be sick. But left at 1245. My chest truly does feel like it has been hit by some thing. I'm in a wrap thing so I can't tell what they look like but um excited. He did end up using two sizes. natrelle series 20, 450cc in the left and 500cc in the right. I can tell in the wrap I will like the size but now to wait to see what everything else looks like!! Updated on 19 Oct 2012: Well...yesterday is a little fuzzy, slept most of the day. As for surgery, I am pretty sure all went well. The doctor said there were no major hiccups and I ended up with Natrelle Style 20 450cc in my left and 500cc in my right. It was the first time I've been under general anesthesia, and had a bit of a rough time out of it, was sick and it took me a little longer to wake up. When i did my chest was soo tight. Today, I have been awake more but still taking pain meds every 4 hours to control the pain. So I am a little loopy and doze a lot. The closes thing I can describe the pain to is having spenth 12 hours per day in the gym for a week only working chest. My muscles are what is hurting. My incisions are not hurting as of yet, but it feels like my rib cage and sternum are. I was surprised, but believe I will be very happy. I want to see what the nipple looks like with the mini-lift he did, but that will have to wait a little bit I suppose. I didn't eat anything yesterday except a bit of crackers with meds, and today had a small bowl of soup. I did have my husband buy some dulcalax since a lot of people say constipation is common. But so far so good...I'm trying to hang in there with the pain, but is just a strong lingering pain not a sharp pain. Updated on 20 Oct 2012: Well day three post op and I am feeling a lot less pain. Unfortunately I haven't been able to eat due to dizziness and nausea. Met with the doc today and he took off the bandages so I got to see them for the first time...ok thrilled. I was so worried I wouldn't like what I saw but I loved them even with the imperfections of being new an swollen. I could not pick but that doesn't do me any good!!! The doc told me to take my patch off from behind my ear, which was anti-nausea and said that's most likely what was causing my dizziness. Took that off and feel a little better already. Updated on 24 Oct 2012: Well I am it is day 6 post-op and so far I am doing well. I had to go back to class on Monday, and the first day I only went to one two hour class and was ready to go back home and rest. Tuesday I was at school from about 9-5 and attempted to do more than I should have, I felt it today. So after classes today I went home and took a valium to relax the muscles per the docs recommendation. The pain is much less, but the tightness is at times extreme. It is a feeling that is hard to explain. I began doing the recommended massages on day 3 and it is not painful as of yet, but the doc said there will be more techniques as I heal that may not always be comfortable. The procedure was not a crescent lift as I thought but an actual periareolar mastopexy so the cut was around my entire areola. I am very pleased so far. I have not completely given up the pain meds yet, so am still taking them, just only half and farther apart, with advil in between. The worst part of recovery by far was the constipation and the final ending of that. I tried everything suggested, stool softeners, fiber, laxatives, prunes, lots of water. I wasn't able to really eat a meal until post op day 5 and that is when my body started moving. It ended up being the worst ordeal last night and after much pain and a feeling of losing my internal organs, I finally think my intestines might be moving. If I ever have to deal with general anesthesia again, I will ensure to prepare before and immediately after, because that was the hardest part of recovery since coming out of anesthesia and the nausea. I go in tomorrow for my one week post op check up....very excited to see my nipples againa and see how everything is healing!! Updated on 2 Nov 2012: Well, it has been two weeks and I am feeling pretty good. I can't claim that I was one of the lucky ones that was feeling great within the first few days, but it hasn't been too bad. After one week I was off of the pain meds and back to driving. However, still need tylenol or motrin for the achiness, but generally speaking pretty good. My pectoral muscles are a little sensitive to picking up things, when I carry things it feels like they just tighten up and don't want to release. It doesn't hurt, its just tight. I have had a lingering pain and swelling on my right rib, but it isn't too bad and that side had more work and a bigger implant so it is understandable. Went in for my 2 week check up and the doc said everything looks really good. I guess he wants me to keep tape on my incisions for a while, said it will help the scarring significantly. I'll take his work for it. Early this week is when I started to feel the ache in my areola area. Before that it was pretty numb. I figure feeling the slight pain is a good thing meaning the sensation is coming back to that area. I'm still tender, hate that I can't carry all of my stuff like normal, and find certain things very uncomfortable. I do not like laying on my back at all right now. I don't know why but it hurts and I can't get comfy at all. Of course can't on my side either. So I'm still sleeping propped with pillows but I find it rather comfortable so I am ok with it. None of the pain is not tolerable. Just a comfort thing. Overall...I'm extremely happy. Finally going to go buy some bras...get to see what size I am! Have been using front zip sports bras for comfort, but ready for regular bras to be able to wear a lot of my shirts again. On that note...very surprised that the majority of all of my shirts fit fine. Updated on 12 Nov 2012: Well, I am three and a half weeks post op and feeling pretty good. I do have a question though, it seems like there is so much implant above my nipple and very little below my nipple. I know things settle down, but would like to know how much it typical to settle down and about how long it takes to have a good idea of what things will look like finished? Also, there is one spot on each breast on the underside that feels firmer and sore. I have an appointment later this week and am going to ask about capsular contracture, but I just would like to know if anyone that has experienced it can provide the signs. I have read online, but it is hard to tell, and it may be where my muscles are healing? I dont know. Any insight is greatly appreciated. Thank you. Updated on 15 Nov 2012: Well...four weeks post op and things are slowly easing up. Of course, I would end up with an uncommon side effect, mondor's disease. I am very relieved that is what it is though because I was very concerned that the area was potentially the beginning of capsular contracture. So while it is annoying and painful, it will most likely resolve itself with no issues. So for now, I'm not wearing a bra because any type sits right on the area and is painful, and taking motrin w/ heat compress. We will see how it all works out :) Still very happy though!!! Updated on 1 Jul 2016: Initial implants October 2012. Submuscular 450cc LB, 500cc RB with perialor lift. RB gave issues from beginning and never dropped into place. PS x3 assumed cc. Capsular contraction repair on Right side left never had an issue. The LB had some tissue hanging off the implant hence the bilateral mastopexy. The new ps told me the right side would be challenging due to the amount of work needed to the pocket itself and recommended reduction of the 500cc to 450cc (allergen style 20 silicon). After surgery he said it went really good and the right did have all the issues he thought, though the contraction was very minimal. He told me my rb looks weird now but that it will loosen as the implant drops. That are was tight due to never stretching from the first implant. He has me in a bando for a few weeks to keep it down. I'm more worried about the Puckering underneath the nipple and cone shape. Will those go away?!?
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