Breast Lift and Implants on a Large-framed Woman?

Thank you for the question.

In my experience, the most common regret “large framed women” have after breast surgery  is that they wish they were larger ( larger breasts) and more proportionate to the remainder of their torso. Instead of selecting a breast implant size prior to surgery I would suggest that you  communicate your size goals with your surgeon.  

In my practice I find the use of goal pictures to be very helpful.   I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" means different things to different people and therefore prove unhelpful.
 


Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate. Placing breast implants on top of the skin ( pre-operative “sizing”) is not necessarily accurate either.


I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. 
 

In regards to the choice of saline versus silicone breast implants:

For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.


On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.


On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.



I hope this helps.

I hope this helps.

It sounds as though you have a great plan to improve your breast aesthetics. A lift is frequently required with an implant after the breasts have gone though lactation. To pick the best size, I would recommend finding some photos of breasts that you like and showing them to your plastic surgeon. Also, try on some implant samples underneath your bra to get a general idea of the look that you desire. Silicone implants are 100% FDA approved and give a very natural appearance with a natural feel over saline implants. Both are safe, and I mostly put in silicone implants. Good luck!