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

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

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