Is a regular Breast Augmentation best for me? (photos)

Had my 1st consult and the board certified doctor recommended two different sized silicone implants, dual plane, through the inframmary incision. Because I am young and have zero kids he says its best to avoid the scars of a mastoplexy (on my left) because there's a chance I will have a nice outcome with augumentation alone and could always come back in the future if I'm unsatisfied with my initial results. So my question is, does anyone think otherwise??

Doctor Answers 18

Breast augmentation

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yes you are an excellent candidate for breast augmentation.  you do have a small element of tubular shape that can be easily corrected with the proper technique. A dual plane technique with radial scoring and the proper shaped implant can leave you with an excellent result. Good Luck!

Breast Augmentation: information

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Dear Ms. 900136,

Thank you for your questions and photos.

I understand your feelings and desires. Unfortunately with out a exam of your tissues I can can only comment based your photos.

Most woman have some degree of breast asymmetry only the degree varies.
This can be caused by:
1)Asymmetric breast inframammary fold (IMF)
2)Asymmetric volume
3)Combination of above

Most likely you will need:
1)differential augmentation (different size implants) if your current breast volume is different
2) a periareolar mastopexy  (lift) to equalize the nipple areolar complex (NAC) and shape the breasts for better symmetry.

Using the sizing technique below (see1below) start with a nylon filled with rice to make your smaller breast equal in size to your larger breast using your current bras. This way you will know the difference in size between your breasts.

I have included some additional information which I hope you will find hopeful.
Breast appearance, size, filler material , shape and implant location is a personal choice guided by the experience of your Plastic Surgeon. Your SPECFIC breast anatomy will
dictate some of your choices.

As far as size you know all bras are not equal in "cup size" measurements.
"Cup size"is a very crude and non standardized measurement and varies by bra manufacturers. Thus actual cup size you eventually are measured at is not as important as your body proportions as it relates to your desired breast size
A)Realizing there are no standard bra (strap/cup) sizes, purchase several bras (full bodied and no padding) of the strap and cup size you think you want to be.
B)take a measuring cup (1 oz=30cc) place rice in a nylon. Therefore 10 oz. = 300cc...
C) try on various volumes of rice with some form fitting clothes.
D)if implant is placed under the pectoralis muscle I usually add 10% volume to what the patient chooses.... To compensate for the muscle pressing down on the muscle and for
the naturally settleing of the implant which often makes the breast appear smaller 2-3 months after surgery.

2) profile of implant:
A) for the same volume the higher the profile the narrower the base width.
B)there is very little difference in projection between a moderate to high profile implant
thus little affect on how the actual nipple will look.
C) the base width of the breast should equal the base width of the implant
D)thus I personally chose the profile based on the patients chest measurements,
(a high profile on a wide chest may not result in the cleavage desired and
conversely a low profile on a narrow chest may result in implant in the outside arm
E)Cleavage is largely determined by your anatomy. This can be optimized by choosing the best profile implant and postoperative implant displacement excercises towards the midline of your chest.

3)Shape of the implant:
A) for the vast majority of cosmetic patients I recommend round implants
B) reconstructive patients shaped/form stable implants are often used

4)Placement decision of implant(subpectoral, dual plane, or suprapectoral) will be determined based on your anatomy and long term goals and benefits.

5)Filler Material
A) silicone gel feels more like breast tissue, less potential rippling, comes prefilled cannot adjust size intraoperatively and larger incisions to place compared to equal sized (non prefilled) normal saline implants.
B) normal saline implants can be adjusted in size intraoperatively, if ruptures normal saline absorbs, potential increase rippling compared to silicone gel, smaller incision to place normal saline implants as compared to prefilled silicone gel implants.

I suggest you collect several nude model photos of the goal breast shape you desire and schedule several consultative appointments with Plastic Surgeons who are experienced and is Certified by the American Board of Plastic Surgery and ideally members of the American Society for Aesthetic Plastic Surgery (denoting by membership as having met additional criteria and a focus on Cosmetic Plastic Surgery).

My best wishes,

R. A. Hardesty, MD, FACS
Diplomate and Certified by the Am. Bd. of Plastic Surgery
4646 Brockton Ave
Riverside, Ca 92506
(951) 686-7600

BA options

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Agree with your first consult. I think you would be very satisfied with your outcome with a BA alone.

Hope that helps and best wishes!
Dr. Morales
ABPS Board Certified
Houston, Tx

Rolando Morales Jr, MD
Houston Plastic Surgeon
5.0 out of 5 stars 44 reviews

You had a good advice. Go for it

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I agree with the adivice you received from your plastic surgeon.  Breast asymmetry is not bad. It does not need to be addressed at this time.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

Is a regular Breast Augmentation best for me?

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Your photos show some asymmetry between your breasts. However, the asymmetry is not significant enough to warrant a mastopexy (breast lift). You are a great candidate for a breast augmentation alone. Thank you for sharing your photos and question. Best wishes.

Dr. Gregory Park

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 178 reviews

Breast augmentation

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It looks like you will likely get a great result from breast augmentation. I think you would benefit from a breast augmentation with a dual plane technique.  It appears from one photo that your left areola is larger than your right. What is it about your areolas bother you?  One option would be to consider a periareolar reduction/lift but as your PS said, this can be done at the time of your breast augmentation or at a later date.   In terms of picking the right implants to achieve your goals, generally speaking, I consider two factors when selecting implants for my patients:

1. Dimensional planning
2. Gel Implant Sizing system

Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.

Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look. Hope this helps.

Dr. Basu
Houston, TX

I would agree with your surgeon

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All the techniques your plastic surgeon have described should get you a good result.  However, one of the last pictures that you posted must have been a result you like.  That picture shows a women with very good cleavage.  You are probably not going to get that.  I tell everybody that they "bring their own cleavage to the table".  It appears that your cleavage is wide and you don't have much tissue over you sternum (breast bone).  You can't put an implant underneath thin tissue and expect not to be able to see the implant.  

R. McIntyre Bridges, MD
Shreveport Plastic Surgeon
4.8 out of 5 stars 6 reviews

Breast augmentation best for me?

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A dual plane breast augmentation with silicone would give you a nice result. From the photos there is no reason to consider a lift. I would approach it through a periareolar incision rather than inframammary as that scar will always be visible and may even be visible in a bra or bikini when you raise your arms causing the bikini top  to ride up exposing the scar. Nipple sensation and breast feeding are not issues with this approach.

 If you are 21 years or over then you can have silicone legally in the US. if younger then you have to have saline.

 Good luck

Roy A. Semlacher, MD
Tacoma Plastic Surgeon

Is a regular Breast Augmentation best for me?

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I agree with dual plane. I also agree that it is not time to do a lift. In order to create more symmetry you may need to have more surgery in the future once the implants settle. I usually measure the volume of the breasts to see the volume difference and be more precise about implant choice. I would go through the breast fold, under the breast (inframammary crease) to place the implants. Your left areola may need to be addressed later on. Good luck!

Azita Madjidi, MD
Houston Plastic Surgeon
5.0 out of 5 stars 6 reviews

Breast Augmentation best for me?

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Certainly you are not a candidate for a mastopexy. You may have slightly tuberous breasts, which your surgeon should be able to address during the procedure. Overall you appear to be a good candidate for a breast ausgmentation

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.