Would a larger implant or higher profile or fat transfer give me more upper pole volume? (Photos)

Question

Had a breast aug and lift but wish a had some more shape to the upper part of my breasts and more cleavage. I got 270cc moderate implants. I think they look good when they are covered by clothes but not in swim suits or necks. I am not looking for large or fake looking breasts. Or would some Lipo around my armpit area help give them more shape?

Ronald J. Edelson, MD · Answer

You obviously had a lift along with the implants. You have really nice result. You could always go bigger to get more fullness but I would leave them as they are. Definitely don’t do fat transfer

Matthew S. Kilgo, MD · Answer

Hello. If you are happy with your current breast volume, I would recommend fat grafting to the upper and inner portions of the breasts to provide more upper pole fullness and better cleavage. Fat grafting allows targeted volume augmentation to help improve shape. A larger implant will help with upper pole fullness but may not improve cleavage if the distance between your breasts was wide preoperatively. A high profile implant will only increase projection and not necessarily provide either better cleavage or more of fullness. Liposuction of the bra roll area may also help improve breast shape. I hope this helps.

Harry T. Haramis, MD, FACS · Answer

More upper pole fullness and cleavage can be achieved with either fat transfer or larger implants.

Fat transfer can be placed in multiple areas- upper poles and inner aspects for the results you desire. Obviously, liposuction of an area is required to obtain the fat.

Liposuction of armpits and around breasts can help give shape- difficult to tell from photos if there’s fat or if that’s the edge of the breast/implant.

Larger implants will give more fullness overall, with more predictable outcome. Some pocket and/or breast tissue may also require attention.

An exam and consultation with your/a plastic surgeon is recommended to further discuss your best options and expectations.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I have been in practice for almost 30 years and revision breast surgery is been a large portion of my practice. In fact, I wrote the very first paper on internal bra-capsulorrhaphy. I find that most breast revision surgeons do not do this correctly and oftentimes rely on meshes to support in an inadequately performed capsulorrhaphy. You should be able have an excellent result with a properly performed capsulorrhaphy and revision of your mastopexy. Best wishes to you.

Gary M. Horndeski, MD · Answer

I recommend a revision of the breast lift and at the same time have fat transfers or place the implants in a higher position.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

Your implants have bottom out some and the inferior pockets could be tightened. You could try going a little larger but will need mesh for more support.  You still won't have full upper breasts because your natural breasts sit somewhat low on your chest.

Darryl J. Blinski, MD · Answer

Based on your nicely posted photos 270 cc moderate profile implants are the incorrect shape and volume for your desired results. Would exchange to a 500 cc high profile implant with liposuction and upper fat crafting under color coated ultrasound. Fee $8000-$12,000.. Virtual consult with.

Mats Hagstrom, MD (license on probation) · Answer

To make a quality assessment regarding the outcome of any plastic surgery procedure we usually need to see a complete set of proper before and after pictures.
If you don’t have before and after pictures and ask your surgeon to forward the pictures they took.
What you look like before surgery allows us to understand your candidacy for the procedure and what could be expected from the outcome.
 Looks to me like you had a significant amount of skin redundancy, and that may have made the procedure a bit more difficult.
Without knowing exactly how the surgery was performed, we don’t know if your pectoralis muscle is supporting the weight of the implant or if gravity is pulling the implant and putting tension on your skin and incision.
Your nipples are pointed straight forward, even though you’re breast are slightly divergent to the sides.
The need for revision surgery after a combination breast lift augmentation is not at all uncommon.
You may benefit from re-tightening the skin envelope.There are a lot of variables to take in the consideration.
To get a proper second opinion consultation, I suggest scheduling those is in person consultations with other plastic surgeons in your community.
For second opinion consultations come prepared bringing with you a complete set of proper before and after pictures and copies of your previous operative report.
These are all part of your medical record that you can obtain by simply requesting them from your current provider.
 Best,
Mats Hagstrom MD

Would a larger implant or higher profile or fat transfer give me more upper pole volume? (Photos)

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