I am having difficulty in deciding the cc. Will have a breastlift with implants. Implant type? Teardrop or round? (Photo)

Please help me to decide on the type of implants with the best desired results. I have been to several surgeons here in Belgium, some say I should go with a teardrop implant, some say round moderate implants. Which is which? I need a cleavage and full breasts. Please advice. Attached are the pictures of my very sad sagging breasts. I wear a 34D push up bra. Would like a cup bigger but not an E cup. What cc do you recommend? very difficult to decide with the bra testers when am already D cup.

Doctor Answers 7

Choosing the Type of Implant

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Each implant have their benefits. #SalineImplants is made with a #silicone outer shell that is filled with saline water during the surgery. It is filled with sterile saline (salt-water). Since saline is like normal body fluid, it is safe and easily absorbed if the implants were to leakThe #implant shell is ordered in a specified size which can be filled to a minimum or maximum fill amount. This allows the plastic surgeon some flexibility with sizing during surgery. Often times a woman has breasts which vary slightly in size. If one breast is slightly smaller than the other, each implant can be filled to a different amount to create better symmetry. Saline tends to be a little less natural feeling than silicone, but it can also create a more dramatic upper breast appearance, which some women prefer. A new saline breast implants option called Ideal Implant™ was recently FDA approved and was created for women who are not comfortable having silicone implants in their body, but desire a more natural feeling implant than traditional saline implants on the market. The unique structure of the Ideal Implant allows for a similar look and feel as silicone with the safety of saline.
#SiliconeImplants are made with a silicone outer shell and are filled with a gummy-bear consistency silicone on the inside. More women tend to choose silicone breast implants due to the natural feel and appearance. Silicone implants are now made of a cohesive gel which are anti-leak even when cut. Look and feel like natural breasts due to the cohesive silicone gel material. New generation silicone gel implants are far superior than those used in the past and have a proven track record of safety. Silicone implants have gone through more testing than any other medical device and are the preferred choice for over the muscle implant placement.
To further ensure the safety, the FDA recommends women have periodic MRI testing to ensure their silicone implants are free from any defects. With both implant types there are choices
#Shaped implants are all #textured and should not rotate when used properly. In my practice, about 20% of the patients benefit from shaped implants. Your Plastic Surgeon needs to measure you and determine the best shape and size of any implants that are used.
Furthermore, a Breast Lift with the Implants may be something to consider.
Getting #BreastImplants without a #BreastLift is usually said to be mistake by many patients who reflect back on the decision. Most breasts will look larger and more droopy with solely implants. They will sag more and sooner, due to the sudden and excess weight. At times it's possible for a “Snoopy” breast or double bubble to develop as a result.

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Which is the best implant size and shape for me?

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The implant type and size you select really depends on the look you are hoping to achieve.  Questions I consider important for you are - do you want a natural or "fake" type of result.  Despite the description you provided of your size, its not ideal for advising you of the best implant.  I would estimate that having a lift you will need around 150 grams or so removed.  Usually in your situation, I would aim to replace a little more than this with an implant around 250 cc.  This will result in a larger breast for you but due to the fact your breasts will be "perky" and lifted, they will appear much larger to you.  In terms of implant  shape, the shape of the breast following a lift is more dependent on the lift, not the implant shape and I find round implants do a great job and offer a very natural shape.   Its important to have a comprehensive consultation with a fully qualified plastic surgeon for examination and  and discussion of your lifestyle to determine the best style, size and shape of implant for you. 

Advice on How to Determine Size and Type of Implant

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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 a bit.Additional critical decisions will also be made by your plastic surgeon such as: whether your implants will be above or below your pectoralis muscle. These choices are recommended to you based on the look you desire, the amount of sagging you may have, and other deciding factors. For more than 25 years, I have tried just about every method to best understand and achieve the patient’s optimal goal. The following is what I have found to be most accurate: To start with, I have found it most helpful for patients to bring in photos from my or other plastic surgeons’ websites to illustrate what they would like to look like. This gives me detailed standardized views and information both qualitative (shape, perkiness) and qualitative (size) and allows me to discuss with my patients how I can best achieve their objectives as well as realistic expectations. For example, though I always tell my patients that I cannot make them exactly the same as a photo because everyone has different anatomical constraints. However, these ”ideal” breast photos are brought to the operating room for reference during surgery so that I have the advantage of “seeing through my patient’s eyes” to best achieve their wishes. Even if the photo does not match their height or weight, I and most plastic surgeons are very good at translating the proportionality of the photo to your features.

I personally order more than one set of implant sizes and use sterile implant “sizers” (temporary implants) placed in the created implant pocket during surgery to know in advance exactly which implant would work best for you in both a sitting and lying down position. This also allows me the opportunity to modify the pocket to meet some of the more subtle shape features desired. This enables me to use my full artistic potential to achieve your desired goals.

I am having difficulty in deciding the cc. Will have a breastlift with implants. Implant type? Teardrop or round?

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Thank you for your question and photograph.  Based on the desired photo that you show you're looking at very large breast implants which may be difficult to achieve when also doing a breast lift.  An in person consultation and examination and sizing system evaluation is necessary to properly answer your question.

For more information on choosing breast implant size please read the following link:

How to decide on size or shape of the implant

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Dear Lilian,

Thank you for forwarding your question and photos.  As for the size choice, there is a sizing system available by mentor that will help you determine what looks best on you. Make sure to find a member who uses this system and wear a thin non stuffed bra for that purpose. As for the shape, in my humble opinion, in breast augmentation they both give a nice final result. The picture you have sent is probably done with a round type. One thing you need to be careful with is that you already have cup D. Don't go much higher than that as this will put you in the category of large breasted women who have their own set of problems.

Best of luck,

Shady Hayek, M.D.
Beirut, Lebanon

I am having difficulty in deciding the cc. Will have a breastlift with implants. Implant type? Teardrop or round?

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Thank you for the question and pictures.   Based on your photographs, you should have a very nice outcome with breast augmentation/lifting surgery. Unfortunately, in regards to specific size/profile of breast implant, despite good intentions, online consultants will not be able to provide you with  meaningful specific advice.  Ultimately,  you will do well spending additional time with your plastic surgeon communicating your goals, questions, and concerns. Do not proceed to the operating room until you feel comfortable that you are both on the same page when it comes to the goals you are trying to achieve.  In other words, careful measurements, dimensional planning, and careful communication will be key.  Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than   breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery.

 Also, 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.  Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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. I have found that the use of words such as “natural” or "D or E cup" etc means different things to different people and therefore prove unhelpful.

 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.  The use of computer imaging may be very helpful during this communication phase.

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.  The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.

I hope this, and the attached link, helps.

What size implants with a breast lift?

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Thanks for your question and photos. Based on your goal photo and your own photos, you will require a full Wise (anchor) mastopexy (breast lift) plus implants. I absolutely agree with your asking what size, and would personally recommend round smooth implants (cohesive silicone) of the largest size your anatomy would accommodate at the time of lifting procedure.

If you had a full lift first (no implants), allowed everything to heal for 6 months or so, and then underwent breast augmentation, you could likely go larger, but this would require two surgical steps (albeit safer and somewhat more predictable ones).

Conversely, single stage full breast lift plus augmentation can certainly be done (I do a majority of lifts plus implants in one surgical stage) . . . BUT, your surgeon may not be able to place implants large enough to fulfill your goals and still be safe for healing and circulation. Basically, this is because tightening skin and then trying to "stuff " it as full as possible may not allow wounds to have adequate circulation and heal properly. Incisions popping open or skin dying for lack of adequate circulation create re-operations and new problems all their own!

So, you might be a two-operation situation anyway. My best advice might be to avoid the unpredictability of lift plus large implants and plan on two stages. I would probably suggest the largest implants safe and appropriate at time of the initial surgical lift, and perhaps this will be just large enough. But if not, once healing and scar softening has progressed for 6 months or longer, larger implants can then be safely placed, and can probably be larger than possible at a single stage. At lower risk.

BTW, you talked about going up about one bra cup size from  D to DD, but not E. Cup sizes are all over the board depending on bra manufacturer, but your goal photographs do not appear to be one cup size more than your present size, IMHO. One cup size increase can be achieved at the time of breast lift with implants in the 250-350cc size range. I suspect you will require larger to achieve your goal photographs. Perhaps not, but that is why personal examination and measurements are so critical in making proper assessments, as well as what is found anatomically in the operating room.

Make sure you see one or more board-certified experienced plastic surgeons who do lots of breast surgery. You may want to call my plastic surgical colleagues Drs. Alex Verpaele and Patrick Tonnard in Ghent (Gent).  Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.