Would 400 CC Moderate Plus Silicone Implants Look Normal on 5'2" Woman?

Question

On December 27th, 2011 I had 325 CC high profile silicone implants placed under the muscle with inframammary crease incisions. I do not like the gap between my breasts. I would not mind increasing the size as long as the space between my boobs decreased. I would like to have cleavage to the point that my boobs would touch in a bra. Would 400 CC moderate plus implants look normal on a 5'2", 90 pound woman? In other words, would the results look natural and real? What about more than 400 CC ones?

Vincent N. Zubowicz, MD · Answer

In my estimation high profile implants often look artificial even in the absence of capsular contracture. I think you should consider the smooth walled gel implants in a sub glandular position. Discuss this with your surgeon.

Gary M. Horndeski, MD · Answer

You are an excellent candidate for a new technique called Implant Exchange with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to exchange your implants, reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall gives the maximum anterior projection with a minimal size implant.  Smaller implants look and feel more natural, are less likely to ripple and are more stable long term.  400 cc’s is not a significant difference from 325 cc’s and will not generate a normal look, however this new technique will.

	 

	Best Wishes,

	 

	Gary Horndeski, M.D.

Curtis Wong, MD · Answer

can be done with wider implants. As for size, 75 cc's is a very minimal amount that won't produce much change in volume. But with wider implants, you will be giving up some projection. A diminished intermammary distance can be achieved but you must be careful to not create the 'uniboob' or symmastia.

Jourdan Gottlieb, MD · Answer

Unfortuantely the attached photo is not helpful to me in addressing your question. An unclothed photo, if possible including one from before surgery would be useful.

	If you breasts are naturally far apart, they will be far apart with implants, which need to be centered behind the nipples and areolas.

	Particularly when we use under the muscle implants, by far the preference of most surgeons, the insertion of the pectoral muscle into the breast bone limits how close to the center the implants can be placed even were one to ignore areolar position. 

	It is more difficult to achieve cleavage with implants as compared to natural breast tissue of the same volume.

	I doubt that larger implants will be the answer to the issues you present. Discuss carefully with your surgeon, and if needed a second opinion. All the best.

Jeffrey Zwiren, MD · Answer

A 400 cc moderate plus implant will have a larger base diameter than your current 325 high profile implant. This will help you achieve more medial fullness. You may require a release of the capsule medially. You will not be able to get the implants any closer to the midline than the edges of your sternum. If you have a wide breast bone it will not be possible to get the implants too close to the midline.

Steven Wallach, MD · Answer

It is difficult to say what might work for you without an exam.  Wider implants may help narrow the cleavage, but in  many ways your anatomy dictates the cleavage that can be obtained.

Tom J. Pousti, MD · Answer

Thank you for the question on picture.  Unfortunately, online consultants will not be able to provide you with specific enough advice to be helpful.

	Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation  revisionary surgery ( regarding breast implant size/profile selection) is:    

	1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.       

	2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as  “natural”  or "C or D cup”  etc means different things to different people and therefore prove unhelpful.  Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.        
	3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.    

	For example, it will be important for you to communicate your goals regarding achieving improved cleavage ( decreased space between the breasts). Some patients  with this goal benefit from capsulorraphy ( internal suture repair of breast implant pockets.  This is especially true if their breast implants “fall to the sides" in the upright or supine position. The use of these internal sutures along with selection of appropriate size/profile breast implants will both help achieve these patients' goals. 

	I hope this (and the attached link) help.

Lisa Lynn Sowder, MD (retired) - Account Suspended · Answer

Cleavage width is more set by your antomy with your sternum and pectoralis muscles than by the size of your implants.  Getting really tight cleavage can sometimes be acheived with detachment of the pec muscle from the sternum, or if the implants are on top of the muscle, getting the two implant pockets really, really close.  But you run the risk of "Unaboob" which can be really, really hard to fix and/or deformities secondary to thinned out breast tissue or an obvious edge of cut muscle.  Also, once the implants are really medial, your nipples may end up to lateral which is not a great look. 

	If you are otherwise happy with your implants, I would advise getting your wanted cleavage with a bra, not with further surgery.

Vincent D. Lepore, MD (retired) · Answer

Changing to a larger, wider diameter breast implant size may narrow the space between the breasts, however there are anatomic limitations. The width of the breast bone, the location of the chest muscle attachments to the breast bone, and the overall shape of the rib cage; all play a part in how close together the breasts will be. Unfortunately, no surgeon can guarantee that your breasts will touch in a bra. As to the size increase of 75 cc from your present implants, this is a moderate increase and should result in a reasonably natural appearance, but you should listen to your surgeon as to there advice regarding a size increase. Best wishes.

David Marcus, MD (retired) · Answer

If your breast implants are soft, not contracted, then you can push your implants to the center and see if the type of cleavage you are looking for is possible. If not, your pectoralis muscle origins may be at the outer edge of your breast bone and there just isn't room for the implants to move any further towards the midline. If they do move inward nicely, then wider implants and/or capsule repair laterally may offer a solution for you. Your surgeon will know this and be able to advise. Going from a 325 HP to a 400cc M+ is reasonable as long as the extra width allows you to retain that sleek look.

Would 400 CC Moderate Plus Silicone Implants Look Normal on 5'2" Woman?

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