Current size 12c. I would like to look like the picture labeled my desired result. Concerned about how to achieve result? (photo

Hello there 



Yes I do think that you have a significant amount of breast sag and are therefore likely to need a lift .

Transaxillary augmentation is associated with the highest surgical revision rate in breast implant surgery so I would not recommend it .

If you have a lift there will be adequate access for the breast augmentation anyway .

The size and shape of the implant would be determined at consultation based on your measurements , your wishes and an imaging session with the Vectra 3D .

You have  a reason able amount of breast tissue and this tends to mask the implant so the actual implant shape won't be so critical unless you are planning to go very large .

Cheers

TS

Thank you for your question and photos. It looks like a lift will be required in addition to placement of breast implants. I do not think you will achieve a satisfactory result with either augmentation or a lift alone. It is best to have an in-person consultation with a board certified plastic surgeon who specializes in cosmetic breast surgery. Ask to see a lot of before and after photos of their work. Hope this helps and good luck!

I appreciate your question.

From your photos, it appears that you would also benefit from a breast lift.  A breast lift would reposition your nipples and reshape your breasts, giving them a more youthful appearance.

The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  



Silicone will give you a fullness at the top (upper pole fullness).



Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.



Anatomic gummy bear implants might be a good choice to give you volume.



These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.



During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.



The best way to assess and give true advice would be an in-person exam.



Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.



Best of luck!



Dr. Schwartz



Board Certified Plastic Surgeon



#RealSelf100Surgeon



#RealSelfCORESurgeon

I think that some form of lift should be considered, particularly on the larger side that has more droop and a larger areola.

Hi there and thanks for the question and photos

In my opinion, you would get a poor cosmetic result with breast augmentation without a breast lift. You would need large implants to fill the loose skin and over time, with the degree of elasticity in your tissues, they will drop significantly, especially in the lower pole where you will see "Bottoming out" or "Pseudo-ptosis".  You exhibit some of this already and it will only get worse with implants. 





I would not recommend transaxillary in you as there is an increased risk of over dissection of the inferior pocket which will make you too bottom heavy.  I believe you need sub muscular implants (probably textured round) with some form of skin tightening procedure to reduce your lower pole fullness.  You could certainly combine this with an asymmetric nipple elevation.







Good luck!  I hope that helps.







Kind regards







Dr Mark Hanikeri MBBS, FRACS







Perth Specialist Plastic Surgeon

Hi there and thanks for posting,The first thing to point out is that your body shape is quite different from the woman in your "goal picture". She has quite a short chest and long abdomen, where as you appear to be longer in distance from your collar bone to the bottom of your breast. The point of this is that you need to be realistic about what you are trying to achieve.Most certainly you need a lift/reduction on your left side. From that point of view, whilst not difficult you are certainly not straight forward. The reason for this is that you have quite significant asymmetry both in breast shape, volume and nipple position.My recommendation would be to use an inframammary incision on the right and a wise pattern reduction on the left (anchor). I would use anatomic implants, the size would depend on your goals and your physical dimensions. I would definitely suggest a submuscular or dual plane pocket.As an aside I think a transaxillary approach would be a disaster for you.I hope that helps clarify things for you.Best wishesRichard

Thanks for sharing your images and storyThe right side is very straight forward, the left side is a little more difficult.I would recommend a lifting procedure of some sort for that side for a number of reasons1) to reposition he nipple at the same height as the right2) to reduce the areolar diametre3) remove excess lower breast pole tissue4) help achieve symmetryImplant size is impossible to give advise on  but I would definitely use a textured anatomical implantDefinitely an IMF incision, a transaxillary incision isn't a good approach to a submuscular pocket when trying to use a tear drop shaped implant. Infact, I would say it is impossible to achieve a reliable pocket and implant placement with that access.I hope this helps and good luck.

Thank you for the question.  Based on your photographs, I think that you will benefit from breast augmentation/lifting surgery. Generally speaking, patients undergoing the breast augmentation/lifting combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with will a significantly higher risk of complications and need for additional surgery.  Again, it will be important that you educate yourself regarding the pros/cons/risks/complications associated with breast augmentation/lifting surgery.









 Remember, that during breast lifting surgery, some skin is removed, thereby limiting the "space" available for breast implants. On the one hand, breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope. These 2 forces are counteracting each other. Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications. 







Generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting surgery ( regarding breast implant size/profile selection) is:











1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.











2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 



In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.



Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.











3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.







I hope this (and the attached link, dedicated to breast augmentation/lifting surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.