5'7", 145lbs. 400cc moderate or 450cc high profile? (Photo)

Thanks for your question.  I think you are on the right track seeking several in-person consultations with plastic surgeons before making a final decision.  They both gave similar recommendations but if you are still trying to narrow down the implant choice, I would recommend booking follow-up appointments.  This would be far more valuable than any advice that could be provided based on photos alone.

Know that breast augmentation and lift procedure together are technically challenging because the two procedure "fight" each other.  They both cause increase tension on the skin and the repairs.   Getting all 4 procedures (two on each breast) to match is a challenge.  If you want to get to the D cup range, this is even a more important consideration with the larger size.  The following recommendation is my opinion and not necessarily "the right answer".I would recommend 450 cc moderate profile plus saline implants placed in the sub muscular plane in the first procedure.  The saline implant are adjustable during the procedure to correct any asymmetry in size and get you to the D cup range.  After at least 3 month of healing, a circumareolar breast lift would be done.  This hides the repairs around the areolar boarder without the downward scar.  The saline implant size could also be adjusted using the same implants at that time.

Thank you for your question and photos.  My recommendation for you would be to ask to "try on" the implants to get a good idea of what they will look like.  Keep in mind that larger volume, high profile implants will give you a more "augmented" look.All the best,Dr. ResultsMiami, FL

Over the last 15 years I have discovered that trying to choose the correct size implant before surgery is futile.  I would choose the surgeon you developed the best rapport with and trust their judgement.  I would bring the photos of the result you like with you to surgery and let your surgeon take them to the OR.  I like to sit patients up during the procedure and use breast sizes to see what the actual implants will look like before I choose one.  This takes all of the guesswork out of the process and makes the decision much easier.  Best of luck

I appreciate your question.

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.

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

In terms of picking the right implants to achieve your goals, generally speaking, I consider two
factors when selecting implants for my patients:1. Dimensional planning2. Gel Implant Sizing systemDimensional
planning – The measurements of your chest wall are taken. Also, the
breast dimensions including the height, width, and current dimensions of
each breast form the basis of dimensional planning. Based on these
measurements, the implant size is recommended. This will give you a
unique breast implant that is suited for your body frame. However, there
are some limitations of what size we can recommend. For instance, some
implants may just be too big for a narrow chest wall. Your surgeon can
review this with you during the consultation.Gel Implant Sizing
system – During the preliminary breast implant consultation, you will
be provided with an option to “try on” a variety of implant shapes and
sizes. You can also visualize the possible outcomes of your surgery
which helps you to get that perfect size to give you the shape that you
longed for. This way your preferences are known and you can then pick a
range of implants that will “fit” just right to give a soft natural
fuller look. Hope this helps.Dr.BasuHouston, TX

If you are having a lift, it will effect the size of implant that you can have at the same time.  When people ask if the implant "they are getting" will be the right size, I presume that their surgeons have determined that choice based upon examination, experience, computer modeling, voo doo or whatever pre-operative means are necessary. Obviously, this is not based upon the use of intra-operative measurements or sizers. If your surgeon has to order your implants ahead of time, and has no consignment implants to choose from, then you will have to trust their pre-operative assessment alone will satisfy your desires. If you don't trust their choice, then you will ask questions on the internet. I prefer to be able to make the final choice after using intra-operative measurements as well, and can do so because of our availability of consignment implants in a wide variety of sizes and shapes.

Thank you for the question and pictures. Based on your photographs, I think that you are an excellent candidate for breast augmentation/lifting surgery. Online consultants will not be able to provide you with very specific advice regarding breast implant size and/or ultimate breast size achieved.

Ultimately, 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, patients undergoing the combination breast augmentation/lifting surgery should understand that there are limits as to how large of an outcome can be achieved, given that breast lifting surgery does involve breast skin removal. 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.

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 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. Best wishes.

It is hard to determine what would be the best implants for you without examining you.  You might need a lift as well.

Thanks for the photos.  I believe a high profile gummy will add a little to the planned lift.  I also prefer a textured implant with my lifts.  The 450cc will be an adequate volume to provide you with a D-cup.  Good luck!!!