Are the chosen breast implants right for me? What would you recommend? Is 450cc (500cc) too big?

Question

Had my consult today. Im torn between 400cc and 450cc sizers. I decided to go with the 450cc because "everyone wishes they went bigger". It was then mentioned that the size up is ordered due to the compression from the muscle. Meaning 500cc would be going in that will end up looking like the 450cc. They will be UHP textured silicone implants. He said I have pseudoptosis and the UHP will give slight lift, lollipop lift after 6m if I'm not happy. BWD12.9,153cm,53kg,10C (5'1,115lb,34C). Want DD.

Damien Grinsell MBBS, FRACS (Plast) · Answer

Hi. You have a tough choice to make. My advice is to have a lollipop lift and then put in smaller implants circa 350-400 cc and this will give the best short and medium term results. If you dont have a lift now you will need the fuller volumes to fill out the skin but the breasts wont look great and will sag more in time. As an aside i think if you are going to go without a lift that you will be a real risk of getting  a waterfall deformity if you have submuscular implants. Regards damien

Jose M. Soler-Baillo, MD, MS · Answer

Thank you for your question and photos.  Implants alone will NOT lift the breasts.  Instead, you will achieve increased volume with the implants that you have chosen.  However, 500 cc's is a significant increase and will most likely cause your breasts to sag further with time, warranting a breast lift.  At my practice, I almost exclusively perform the full breast lift procedure due to highest quality results it produces amongst the breast lift techniques, so I would advise that you seriously rethink a lollipop lift.All the best,Dr. ResultsMiami, FL

Sheila S. Nazarian, MD · Answer

Choosing the right size implant depends on any number of factors all of which require an in person exam.Based on your photos, you look as you would do best with a breast lift with an implant. You might want to see a second in person opinion. My best,
Dr. Sheila Nazarian
@drsheilanazarian on Instagram

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link.#breastaugmentation#findingtherightsize#BA

Peter A. Aldea, MD · Answer

Life would be so great if we had identical replaceable parts. We we would not need blood banks. There would be only one blood type. There would be no need for organ donor registries. We could all receive organs from everybody. People could get fat donations from everybody who wished to get rid of some fat since no organ including fat would be rejected. There would be no need for psychologists and psychiatrists since we would all be the same in every possible way. And yes we would not need to understand the subtleties of breast augmentation and the way each implant affects the breasts. But obviously this is not the world we live in. You our have asymmetric breasts much like 99% of women and your breasts are sagging. Adding more volume and weight to the breasts will not lift them in the long term but make them more saggy. So if you want perky breasts with similar volume to what you have now you should be having a Breast Lift. If you want larger and perky breasts you should be having an Augmentation Mastopexy. When it comes to picking an implant you should pick whichever implantS ( there will be a few not one) are covered and concealed by your current breast tissue. Getting implants which are wider will be visible as ripples. If you really want to SEE how the more suitable implants would look IN you forget about sizers, rice bags and the rest of this unreliable junk. See a Plastic surgeons who offers 3D imaging. Systems like Canfield's VECTRA will take a 3D image of your chest and you can then see from every possible angle how each breast implant would look inside your chest. Better yet you would see the subtle differences between implants as it would look on you. Please do your homework. Peter ALDEA MDMemphis, TN

Mark Hanikeri, MBBS, FRACS · Answer

Hi there and thanks for your question and the photos.  It is a little hard to advise you and truly interpret what's going on due to the donuts in the photos but my impression based on what I see is that you should definitely have a skin reduction and nipple elevation procedure at the same time as the augmentation.  You have quite a bit of your own breast tissue and so I believe a submuscular augmentation will result in the "snoopy dog"  appearance as the breast gland sags over the relatively fixed submuscular implant.  This is more likely with a round implant than a tear drop shaped one.  The size of implant is best judged by your plastic surgeon after a face to face consultation but I think the sizes you are considering are quite large for someone with as much tissue as you (C-D cup), especially at 153cm and 53kg!  You will be something like an E-F cup after augmentation and as you are very slim will look very top heavy.  If that is what you want, that's fine but as you also appear to have quite loose tissues, I believe you will tend to sag quite a bit with implant that large.  Also, as you say, there is some "Pseudoptosis" and also perhaps some mild "real" ptosis.  Under these circumstances, I feel the lower pole of your breast may be too long with a lollipop lift and you may need to be prepared to reduce the skin in the lower pole with a short horizontal scar as well.I hope that helpsKind regardsMark Hanikeri MBBS, FRACSPerth Specialist Plastic Surgeon

Are the chosen breast implants right for me? What would you recommend? Is 450cc (500cc) too big?

Answers (6)

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