Please help me decide on 400cc vs 425cc vs 450cc high profile silicone using the dual plane technique? (Photos)

Question

Hello! Intern medicine resident here finally scheduled for BA 3/9 Yay! I'm well aware this is highly variable and the differences between 400, 425, 450 are nuance at best. Given that I am 25yo, 5'5ish, I live around 115-120lbs, no kids or hx of breastfeeding nor desire for either in the future, exercise consists of yoga 3-4x/wk, current size is 32C of 34B with ptosis and wide sternum, what are your thoughts? Final sizing tomorrow. Thanks in advance

Gary M. Horndeski, MD · Answer

Thank you for your question and photos,
Implants are not enough.  You need a breast lift that will use your own tissue to fill the top of your breasts. The Bellesoma Method was not only designed to achieve upper pole fullness without implants, but has also eliminated the dreaded vertical scar component. Breasts are beautifully reshaped and elevated with minimum scarring. Long term results are this technique's hallmark. An internal support is fashioned using a woman's own tissue to keep the newly shaped breast high for years to come. Nipple sensitivity along with the ability to breast feed is also preserved. Remember, implants are not stable devices and as such require maintenance in the form of costly revisions. I hope this helps. 
Best wishes and kind regards, Dr. Gary Horndeski

Andrew P. Trussler, MD · Answer

Breast ptosis and a wide rounded chest would be very difficult to augment with a high profile breast implant without a breast lift. The tendency for the implant to be malpositioned is great and the thought that any dual plane would correct this is a long stretch. Choose the implant wisely and the procedure wisely because one proper procedure is more effective and long lasting.

M. Scott Haydon, MD · Answer

Thanks for the photos and the question. Congrats on going forward. I think you are correct with regard to your assessment of your breast shape, sternal width, etc. My concern about a HP implant is that the more abrupt takeoff of the implant might make it more pronounced. I have used external sizers, but in your case I don't think you get a real idea of what the final result will look like. I think the Vectra 3D imaging is a much better predictor. It also would allow you to see a 350 or 375 MPP vs a 425 or 450 HP and see what shape you like the best. Best of Luck!

William Andrade, MD · Answer

Hello,  some of my patients will choose exactly the approach you are taking, and accept that the nipples will still likely remain lower on the breasts (even the dual plane pocket has limitations).  Others will have a breast lift to improve the overall shape, but of course there are more scars with this approach.  Ultimately it's a personal decision made after a discussion with your surgeon.

Ven Erella, MD · Answer

Thank you for your question. Size of the implants depending on the measurements of your chest and your goal. You have ptosis. Ideally lift with implant is best for optimal results. If only implants then large implant is likely choice to compensate low positioned nipple. Please talk to your PS

Robert Whitfield, MD · Answer

Your decision can be made a little simple with your exam, goal pictures, the use of sizers, followed by the 3D imaging.  I use the photos of each patient to give them an idea of their expected appearance.

Tom J. Pousti, MD · Answer

You are correct in that the differences between the breast implant voulmes you are considering are  not very significant and usually barely perceptible clinically, depending on the patient's body type.  Much of the decision-making will depend on your goals, which you should carefully communicate with your plastic surgeon. For example, if you feel that you will be more disappointed if you are "too small",  your plastic surgery may be able to use the larger breasts. On the other hand, if you feel that you will be more disappointed you are slightly "too large", then  the implants in the lower range may be the better option.  If you are undergoing breast lifting also,  additional safety considerations will likely come into play when it comes to selection of appropriate breast implant size. Again, make sure that you communicate your goals/preferences very carefully with your plastic surgeon; it will be important that your post on the same page prior to proceeding. Best wishes for an outcome that you will be very pleased with

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