Confused after receiving multiple consults & recommendations, what size and profile would you recommend for me? (photos)

It is okay to get to varying opinions about a particular procedure. When you start to have multiple consults and multiple multiples with the same person you get to much information that can lead to considerable confusion. I would suggest a couple things one you might consider waiting to have a breast augmentation after you have your family. Number two you have to trust the surgeon that you feel most comfortable with and rely on his or her judgment. Good luck.Earl Stephenson, JR, M.D., DDS, FACS

There is no way to guarantee a particular bra size. Bra sizing varies greatly between bra manufacturers and a C in one bra will be a D in another. What matters more than the assigned bra size is the way the implant looks on you. The best option for your body and aesthetic goals can be determined in a thorough implant sizing session.Implant sizing depends on several factors. One of the most important factors is your breast width. Generally, your surgeon will measure your breast width, and then provide you with a range of implant sizes appropriate for your native breast size. There are more nuances to it than just what I've described, but this approach works for most women.I usually have my patients bring in a large bra and a tight t-shirt to do sizing. I'll then choose 3-4 implants that I feel are appropriate, and have my patients place them in the bra under the tight t-shirt. My patients can then look in the mirror and get a good sense of what they will look like with the provided implant sizes. My patients like this approach and get a great idea of how they will look.By using this technique, your surgeon can outline a range of appropriate implant sizes that will be aesthetically pleasing, and you make the final decision.I hope this helps. Good luck!

At size 34 A each 100 cc’s of implant
corresponds to 1 cup size change. 300 cc
implants would take you to a D. I always
recommend small round textured silicone gel implants placed retro-pectoral
since they look and feel more natural, are more stable, less likely to ripple
or have complications needing revision.
Implant profile is irrelevant in the retro-pectoral position since the
muscle compresses it. Since you are very
active, I recommend the smallest implant possible, which will have less
displacement with muscle contracture.Best Wishes,Gary Horndeski, M.D.

You certainly have done your homework, and considered your
options. The descriptive paragraph you provided is very helpful. You have
experienced firsthand that each surgeon may provide different recommendations
based on practice philosophy, their individual patient experiences, and
beliefs/biases regarding implant styles and types.



Implant selection can be a complicated process, and requires a
complete patient examination and detailed consultation to reach that decision.
Therefore, in many respects, the surgeons that have already examined you in
detail are in a much better position to provide recommendations then anything
someone else can tell you over the Internet.



In addition to base width, skin elasticity and breast skin
envelope compliance are also important in the implant selection process. You do
have a good starting shape, and so with a moderate augmentation, you should get
a very nice result. I agree that a silicone gel implant would be your best
option. With your continued desire to be very physically active, a subglandular
implant position may be better, but this location does have a higher risk for
capsular contracture. The Natrelle 410 would complement your preoperative shape
very well. However, if you're going to continue to be extremely physically
active, it would probably be best not to utilize this implant in a subpectoral
position since there is likely increased stress placed on the shell as a result
of the textured surface and its integration into the breast capsule.



I prefer subpectoral implant placement (greater tissue coverage,
lower risk of capsular contracture, less rippling, improved mammography) and an
inframammary approach (ability to make a longer incision, control of the
inframammary fold, good exposure, reusable) because of the benefits they offer.



The simulation photograph you included certainly shows a nice
result using a 375cc high-profile (style 20) round gel. You mentioned that you
don't want your breasts to have a "softball look" or be "torpedo
boobs". A high profile implant is more spherical in shape, and out of all
the implants, is most likely to give this type of look. I believe high-profile
implants also direct greater biomechanical stress on the breast anteriorly and
inferiorly. In patients with less skin elasticity, this stress can lead to
stretching of the inferior pole skin (over time), and additional implant
descent, producing a high riding nipple-areolar complex. For these reasons, you
may wish to consider a moderate profile (style 15) implant instead. This may
mean that you have to settle on a slightly lower volume, but in the long run
may achieve a better result.



There will be advantages and disadvantages to every decision
regarding pocket location, fill material, implant style, and implant size.
Ultimately you should settle with the surgeon that you believe understands your
needs the best, and (the one you trust) will give you the results that you
desire. I hope this was helpful. Best wishes.

Way too many moving parts here, you need to pick the doctor and tell him or her what you want in your own words, it seems you are being moved around. With your anatomy and desire to workout I would likely do 270 under the muscle

Hi LexiBurke.This is not a snarky answer, and I think likely different from any you will get from others.  I think you need a time out.  None of us posting on this site can tell you any better than a doctor who has had a hands on physical exam.  There is way more to this than measurements.  Judgement, experience, tissue conditions, ribs, spine, muscle, patient expectations, and on and on.You have had so many consultations that you basically know all there is to know, except how to make a decision.  You know that there are many ways to do this procedure and everyone has a unique opinion.  In the end, only your satisfaction counts.  You must choose wisely, but how?Take a time out.  Promise not to think about this for a month.  It will percolate in the background.  Choose the top 3 surgeons and no more.  Go in for another consultation with questions.  Have the doctor put actual implants in a bra for you to try on and see how you like or don't like it.If you don't get an "a ha" moment, take a time out, and it will come to you.I know it is tough to decide, but you may be over-analyzing this to the point that you are confused.  Time will help.sek

You are getting confused because you are getting too many consults. Then you are now making matters worse by asking the blogosphere for even more information. Cosmetic surgery is a combination of art and science. Plastic surgeons are not all the same, and there are many routes to an excellent result. So get a referral from a friend to someone she or he has faith in, see that doctor and proceed with surgery. It is not your job to make every detailed decision about surgery. If you are the expert, why would you pay someone else. A cosmetic tic procedure is supposed to be fun, NOT painful.

Your situation is not uncommon for patients who seek out multiple opinions. Part of it is probably the various philosophies, experiences, and biases of surgeons and part of it is the nature of breast implants. All implants have advantages and disadvantages to their uses. There is no single implant that gives a patient everything without some unwanted side effect or potential complication. That is why there are so many choices. The goal has to be to find a best fit procedure that produces a result that you can be satisfied with (not necessarily your ideal result) with the side effects and risk profile that you can tolerate. Rarely can you get everything for nothing. I cannot advise you on the specifics of your surgery without a full examination and a comprehensive consultation process that I perform over multiple meetings. Often it is not the specific operation that is done that is important (since there are situations where the choice of implants is relatively irrelevant and other situations when the choice is paramount) but it is the relationship and trust in a surgeon's specific philosophy that is more valuable.Robin T.W. Yuan, M.D.

Agree with Dr Hartog's reply. But you have so many contingencies that the choice is made very difficult. I might based only on this brief written prose and computer imaged photos consider the tear drop Sientra implants above the muscle. BUT you most likely are one of those patients that might always find an issue and strives for perfection but we unfortunately never reach it and MUST compromise. Good Luck... 

The good news for you is that you have great shape to start with, so you should get a great result no matter which option is chosen. There are pros and cons to every approach to breast augmentation and the various implants. You will also have to set your own priorities. If working out with a lot of pectoral muscle activity is your priority, then yes, you may be better off with subfascial (sub glandular) implants - the trade off for this will be a statistically higher capsular contracture rate.With regard to size, the first priority is to decide how big you want to be - remember this is for you. Use the computer imaging to help you make a decision on how you want to look. Then as long as the size is within a reasonable range for your frame, go with it. I find that many people agonize over what is right and wrong, there is no right and wrong, there are simply pros and cons of each approach. Balance these pros and cons according to your needs and choose a size that makes you look the way you want to look within a reasonable range.