69kg, 5'11 transwoman for a mini boob job like a fashion model (photo)

Question

69kg, 5'11 transwoman looking for a subtle breast implant much like a typical fashion model. I've seen 2 doctors who said 350 to 400cc mentor moderate would work with my wide chest. I'm a little worried its going to look average volume since i want the whole aesthetic to be more on the smaller size and not average volume. would it also work if i request for a low profile implant for that small and droopy look?

John Reilly, MD, FACS · Answer

Thank you for your question. Great job on the measurements 
Some things to consider. First identify the desireble characteristics of the breast in the photo. It appears to be a breast with good transition. There is subtle change when going from the bottom of the breast to the nipple and then to the top part of the breast. In addition, the distance of the nipple from the side of the breast is optimal, centralizing the nipple.  There is a certain proportion of the volume of her breast below the nipple compared to above the nipple. To make a bottom heavy looking breast place more of the volume below the nipple compared to the standard.

Your left fold is lower than your right fold. Is it safe to lower the right fold without the risk of a double bubble deformity? This is a discussion and a decision with an experienced plastic surgeon. 
 
You are right in that a lower vertical height implant would be optimal. Choose a flatter implant even if it's wider as opposed to a less wide implant with a central projection that would exceed the optimal.  I would also consider a few implant size options below 350. Your surgeon can use a fairly inexpensive sizer in the operating room to assess the effects of multiple different implant volumes. Make sure you and your plastic surgeon are on the same page!.  Good luck.

Krishna Vyas, MD, PhD, MHS · Answer

It sounds like you are aiming for a natural, subtle look, which is definitely achievable with the right approach to breast augmentation. Opting for a low profile implant can help achieve a softer result compared to a more rounded moderate or high-profile implant. Low profile implants often have a wider base and project minimally from the chest wall. This could give you that "fashion model" aesthetic you're going for. Implant sizers are one way to determine your desired size; these are gel-filled implants placed in your bra to help you try different volumes and see how different sizes might look on your body. This step helps you get a better sense of what to expect, and it allows you to fine-tune your preference based on what feels most comfortable. Your surgeon will recommend the size and shape that suits your anatomy and will help you achieve your desired outcome. They will take into account your breast width, existing breast tissue, and overall body proportions. It’s always a good idea to communicate your exact vision and aesthetic goals clearly with your surgeon so they can help tailor the procedure to match your ideal outcome.

ABOUT DR. VYAS
Dr. Krishna Vyas, MD, PhD, MHS, is a highly trained plastic surgeon specializing in aesthetic surgery and breast surgery, including breast augmentation, reduction, lifts, and gender-affirming surgery (such as chest masculinization and feminization). With advanced training from institutions like Harvard, Mayo Clinic, and Johns Hopkins, Dr. Vyas is recognized for his expertise in breast and chest sensory nerve restoration. His PhD in clinical and translational science focused on stem cells, fat grafting, and improving outcomes in aesthetic surgery and breast surgery. Dr. Vyas has served on the editorial board for several medical journals and platforms and has over 200 research papers and talks. His research focuses on aesthetic surgery, regenerative medicine, stem cell biology, fat grafting, breast surgery, and gender-affirming surgery. Recognized for his expertise, Dr. Vyas was appointed an Instructor of Surgery at Mayo Clinic and served as an Assistant in Surgery at Harvard Medical School and Massachusetts General Hospital.

Dr. Krishna Vyas, MD, PhD, MHS
Harvard, Johns Hopkins, & Mayo Clinic Educated
Double Fellowship Trained 
Aesthetic Plastic Surgeon
New York, New York

Warren Schutte, MD · Answer

I feel that it is very important to try implant sizers on prior to choosing a cc size. That is the only true way to see if you like that volume. I encourage you to, with an open mind, try on implant sizers and see what you like. You are correct. If trying to mimic the inspiration photo, you will want a lower profiled implant.

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