What would be suggested lift and size? 36C to DD high profile

Question

36c to a DD, 5’4 165 lbs recently told 600cc saline donut lift under muscle Left side slightly bigger by about an inch Loose skin on top Photo with bra has the sizer of 550 Other photo in dress is my goal look. I’d like to be able to wear a bra or go bra less in certain shirts/ dresses Would they sag really quick at that size or get huge after they settle

Pejman Aflaki, MD · Answer

Hello and thank you for the question.  An in-person consultation is needed to give you a useful advice and I would suggest that you discuss this with your plastic surgeon. Many factors including patient's desired breast size, skin envelope (both quality and quantity) and breast width diameter among others are important in selecting the implant size. Choosing the right implant should be a shared decision between you and your plastic surgeon. In a typical consultation, you try a variety of in-bra sizers and in combination with several other measurements that your surgeon will do, the final implant volume is selected. Use of 'goal pictures' is  also an effective way to communicate your goals with your plastic surgeon. My best advice is that you communicate your goals and aesthetic ideals with your surgeon as clearly as possible and trust your surgeon's skills and abilities to deliver what you are looking for.
Best wishes and good luck,
  
Pejman Aflaki, M.D.
  
Johns Hopkins-trained double board-certified plastic surgeon

Matthew J. Nykiel, MD · Answer

Hello and Great Question. I appreciate the time you are spending researching this procedure. My name is Dr. Matthew J. Nykiel. I am a Board Certified Plastic Surgeon, a Fellowship Trained Cosmetic Surgeon, and a Breast Augmentation Specialist.
Based off your photos you would need to do an in person consultation with a board certified plastic surgeon who specializes in this procedure and who can take measurments and walk you through step by step to determine what size would be suitable for you and your lifestyle.
I hope that helps! Best of 
Luck! 
Matthew J. Nykiel MD

Kenneth Hughes, MD · Answer

An American Board of Plastic Surgery board certified plastic surgeon will be able to guide you to the correct size implant for your measurements and desires.  Measurements of the chest wall and breast imprint width as well as knowledge of all breast implant sizes and profiles should make this process easy. 
None of the modalities to approximate final results from breast implants are 100% accurate; they merely facilitate the patient and the board certified PS concurring on the size and type of breast implant which will come the closest to reaching the patient's goal. My patients prefer to try on sizers under garments they typically wear (a tailored blouse, tight sweater, swimsuit, workout clothes, tank tops, and etc.) so that they have the best idea of whether the garments fit as desired with the implant selected and help allay some of their trepidation associated with this decision. I would recommend that you go with the size that boosts your self-esteem, and fits your anatomy

William Andrade, MD · Answer

Thank you for your question.  Implant sizing requires a proper physical assessment including detailed measurements, in order to determine which implants are appropriate for your body type.  As for the best breast lift, I personally prefer to do a "tailor tack" lift after inserting the implants, meaning that the exact markings and incisions are customized during surgery.  I find that this gives me better outcomes rather than just picking a certain procedure before I will even know how the implants will change the shape of the breasts.  However, each plastic surgeon has techniques that work well in their hands, so your surgeon might have a different approach.

Daniel Barrett, MD · Answer

Dear sa1988,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Donovan Rosas, MD · Answer

Patients often think in terms of cup size when considering augmentation. Unfortunately, devices are sized in terms of milliliters (cc) of volume. This can lead to some confusion when sizing. Additionally, it is important to remember that cup size itself is not standardized with variations from one manufacturer to another. Unfortunately, as many women can attest their cup size in an industry leader such as VS is not necessarily transferable to another brand.
Another point which is often under appreciated is that of anatomy and starting point. Any implant will add volume to the volume which is already present. The implant is additive. A particular volume will not necessarily confer the same cup size to different patients (often times it will not even confer the same cup size to different breasts in the same individual...remember they are "sisters" not "twins"). 
A general rule of thumb is that 125cc can represent somewhere between 1/2 to a full cup size increase. Smaller volume differentials (25-50cc) are typically less consequential representing a volume change of less than a shot glass. However, I have found these numbers, at least anecdotally, to be of little help. Patients often present with notions/goals which do not correlate with these sorts of sterile volumetric assessments.
When sizing patients, there are a number of useful tools including:
-3D imaging (has the added benefit of offering a volumetric analysis of the pre-operative breast)
-Breast sizers (rice bags)
-Goal photos
I also recommend that patients commit to a particular look rather than a cup size. Once a patient settles on a look that pleases them the overall cup size increase becomes less relevant.The key to obtaining a natural result is to stay within the parameters defined by your BWD. 
With regards to your goal photos, it is important to consider relativity. The subject in your goal photo is very slim which accentuates or exaggerates the size of her breasts. She may be smaller than your current size but the contrast between waist and bust creates the illusion of size. Goal photos are most helpful when the subject is a reasonable reflection of yourself.
As always, discuss your concerns with a board certified plastic surgeon (ABPS).
Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic Surgery, American Society of Plastic Surgeons
RealSelf Top 100
RealSelf Hall of Fame

Mark K. Markarian, MD, MSPH, FACS · Answer

Hello and thank you for your question.  Based on your photographs alone, you may benefit from a breast lift with implants.  However, your goal pics are misleading because that individual is slimmer, and her breasts look relatively larger, despite likely being the same size, if not smaller, than your breasts.  I think you would benefit from an in-person consultation with a board certified plastic surgeon who can fully evaluate your breasts (and body), to devise a concrete surgical plan to help you achieve your goals.  This may include liposuction and/or breast surgery.  Good luck.
  
Mark K Markarian, MD, MSPH, FACS
  
Harvard-trained Board Certified Aesthetic Plastic Surgeon

Camille Cash, MD · Answer

Selecting the appropriate size, style, and type of implant for you is best done in person.  The implants you are considering will produce a cup size much closer to DD than C.  The higher profile will produce the upper pole fullness you are wanting.  The elasticity of your skin combined with the weight of the implant will determine if/when the breasts begin to sag.  I encourage you to discuss your concerns further with your surgeon who can help you select the implant best for you.

Erika Sato, MD, FACS · Answer

It is hard to give you specific advice for the actual size and profile of implant without seeing you in person and taking measurements. I personally would not get 600cc saline implants if your goal is to go without a bra. This is a very large size and saline are heavy. Why not consider silicone?

Connie Hiers, MD, FACS · Answer

To determine the best range of sizes, you need to be examined and measured. The 600 cc implant is large and heavy and may gradually sag over time. I do not recommend going without a bra with heavy implants. You do need to try on that size and feel the extra weight on your neck and shoulder. Please do not choose an implant that is too large for your frame and tissue.

What would be suggested lift and size? 36C to DD high profile

Answers (12)

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