I Wanted Upper Pole Fullness, Why Didn't 960cc Get Me This?

44DD Pre-op and Had a Lift and Aug with Saline 960cc Mod Plus Implants Now I'm a 44DDD. im 34 5'6 and 200lbs, with 2 kids. i wanted to go to a full size F with upper pole fullness and the high fake look, with the round look at the top of my breast. i look saggy and small with no upper fullness and my breast have no roundness up top. i want to go ALOT bigger in the future but i'm wondering what happened and why did my breast turn out like this??? Please help!!

Doctor Answers 7

Will 960 cc implants rise to the top???

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I think Dr. Aldea makes some really good points. You may have asked for these large implants, but the surgeon should also know and advise accordingly when the patient is asking for something unrealistic. He/she needs to be the patients advocate.

I know that not everyone shares in my opinions, maybe even the minority, but the fact is that if you appreciate the fact when you perform a breast augmentation you are placing a foreign body into a living structure, and the tissues thereof will change. The breast implant will not change. There will be stretching of the tissues and if the elastic capacities of the tissue are exceeded the tissue will lose elasticity like an old pair of underwear.

These issues have been well studied. If you exceed the recommended volumes for a given breast as determined by its dimensions and tissue characteristics, the downtime, pain, numbness, incidence of (or need for) revision and creation of potentially uncorrectable deformities will accelerate accordingly as well as losing any chance of a natural result. If this is important to a patient, and I know it is to my patients, then these issues need to be addressed and respected.

Just like nature has laws of physics such as the law of gravity (which we cannot change), nature has laws of tissue interaction. If you place a large implant into the breast, there will be forces created on the breast tissue due to the force of the implant stretching the breast tissue and the force of the implant upon the tissue due to its gravitational weight pulling the tissues downward. The first force will result in thinning of the breast tissue, loss of tissue elasticity and possibly chest wall deformities (ie from high and extra high profile implants) and the second will result in stretching of the tiisue envelope.

In your case, you are overweight (BMI = 32 in your case - >25 = overweight, > 30 = obese), had DD breasts (which are hardly small) and want to place super large (960cc) implants and want a full, high, fake look.

The problem is that placing implants will not change the quality of your tissues, and will not rise ot the top of the breast. In contradistinction, these implants will sit low on the breast, and then all this DD breast tissue that you have will sit in front of the implant and sag off of it just as it does now off the front of your chest wall.

The only options that I see for you are either to do nothing or undergo a breast reduction, which will, arguably, make you smaller but the breasts will be lifted. The upper pole fullness will be short lived as Dr. ALdea stated. A bra will be essential to help preserve your new look for as long as possible and to give you the look you want while supported in clothing.

Stony Brook Plastic Surgeon
4.9 out of 5 stars 244 reviews

Upper Pole Fulless after Breast Augmentation/Lifting?

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I'm sorry to hear about your disappointment with your breast augmentation/lift surgery.

Unfortunately, it is very difficult to achieve the “round” look on top while undergoing breast lifting surgery at the same time.  This has to do with the issue of skin elasticity and the limitations of the breast augmentation/breast lifting operation.  However, the  “full round look” can usually be achieved  with additional surgery.

It may be helpful to you to submit pictures  to allow for more accurate  advice.

Best wishes.


Not full up top

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I think what is happening is that your skin cannot support the weight of the implant and the lower pole skin stretches and the implant drops. A larger implant will likely go through the same process again. That fake high look usually comes when the patient has some element of capsular contracture that is not allowing the implant to drop, and we cannot cause that to occur evenly.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

960 cc implants?

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Using excessively large saline implants over filled to 960ccs is going to lead to potentially more problems than a smaller implant.  Upper pole fullness depends upon your anatomy to some degree. A lift may push them up but eventually some of that upper pole descends as the skin and soft tissue settle down. Bigger implants will cause it to come down sooner. 

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

960cc implants didn't work to give "upper pole fullness and the high fake look."

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I'm not sure what kind of lift you had, but your surgeon likely removed only 1-2 ounces of "extra" skin to lift and tighten your skin brassiere, while adding over 2 POUNDS of implant per side! I'm surprised that your breast incisions healed with this much additional volume per breast. I'm conflicted as to whether or not I think your surgeon is heroic for attempting to achieve your goals, or a total idiot for accepting your challenges as even remotely possible!

Gravity cannot be overcome by even the most skilled surgeon and the most advanced breast lift techniques. Perhaps if you are unlucky enough to develop severe capsular contracture, your breasts will become high, tight, hard, and round, but gravity will still pull inexorably at your chest, shoulders, and back, and you will then be asking different questions!

You state that you want to go "ALOT bigger in the future" but that is neither possible (implants don't go that large in the United States), nor a solution. Bigger is even heavier yet, and gravity will continue to exert its forces on your body.

Just because you wanted what you did, and despite your surgeon doing his best, you cannot rewrite the laws of physics. Sorry, but this is not the fault of your surgeon; yours is an impossible goal!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

No upper pole fullness - gravity and stretching of your tissue is the issue!

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What you needed was some advice and insistence that the decision to use such larger implants was a bad idea. Unfortunately, you and your surgeon made a decision together that used flawed logic. Like many other things in life, you can not always have what you want.

Plastic Surgeons have a responsibility to educate you about the consequences of excessively large implants and tell you to not have surgery like this. However, you have a responsibility to listen to the advice and to be realisitic. How will larger implants not result in more gravitational changes and stretching of your tissues?

Dr. Mosher 

Mathew C. Mosher, MD
Vancouver Plastic Surgeon
4.5 out of 5 stars 34 reviews

When it comes to Breast Implant Size, is the Sky REALLY the only Limit?

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You started with large (44DD) AND sagging breast which were "treated" with the largest non-custom saline breast implants on the market inflated to 960 cc (2.1 pounds) per breast and had a breast lift which surprisingly did not last. It left you with sagging 44DDD sagging breasts without upper pole fulness.

You are frustrated and you ask emotionally ask: "what happened and why did my breast(s) turn out like this?"  Do you think you may have any role in your outcome or is it juust the fault of the Plastic surgeon who gave you what you asked for?

And now, when you spent a lot of money to get a substandard result what you you ask for ? " I want to go ALOT bigger in the future"...

Look around you, and point to one living being which is immune to the effects of aging, weight and gravity. They do not call it the LAW of Gravity without a reason. If a feather or a speck of dust falls to the ground. WHY would a 2 pound weight float up like a helium balloon?

So - what is the solution to large, heavy, sagging breasts?  A Breast Reduction. 

If you want large breasts you must accept the certainty that any upper pole fullness will be short lasting and the breasts will sag. 

Think about it. I realize it is a frustrating and hard choice but it is the truth.

Peter A. Aldea, MD
Memphis Plastic Surgeon

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.