45, 5'3, 148lbs, 275cc, silicone, right implants for me - subglandular? (Photos)

Thank you for your question. A large portion of my practice is dedicated to breast revision surgery. I have been in practice over 28 years. I have some perspective for you. No one wants a lift! Your anatomy dictates the procedure that is needed, and you definitely need a lift. I have seen your scenario to many times over the years in which the idea is: "placing a larger implant over the muscle to fill up the skin envelope so that you do not have to have a lift". In theory, that would work if we lived on Mars. I have a whole gallery online titled " term complications associated with implants placed on top of the muscle". Please look at that. What I see is people who are already drooping place an implant which adds more weight and more drooping. That being said, you should be able to have an excellent result with an implant placed under the muscle and a lollipop lift. Best wishes to you.

Based on your photos, I think the 275 cc implant will fit you very well. I assume since you don't like the rounded look, you are getting a moderate profile implant. This is a less projecting implant that will give you upper breast volume and a natural slope to the breast. Good luck!

Hello, I am Dr. Salvador Garcia, from Guadalajara, Mexico, I would offer you to do a simulation with the Crisalix program, so that you can see with artificial intelligence your closest result with different implant measurements, in addition I would recommend using a Motiva Ergonomix implant to give it that naturalness you are looking for

I recommend performing an anchor type breast lift pattern at the time of your breast implant insertion. I believe that you have too much skin/breast tissue laxity to achieve the look you are seeking without a lift. I would highly recommend placing an appropriate size implant and performing an anchor-type lift pattern. I recommend finding a plastic surgeon with at least 6 years of integrated plastic surgery training followed by an accredited aesthetic surgery fellowship (by the Aesthetic Society).

Hello,
Given that you have a decent amount of your own breast tissue, I would think that once the implants have fully settled you will not notice much of a change with 275cc implants. One of the main reasons patients are dissatisfied after breast augmentation is that they wish they had gone bigger.
Having an "unnatural" look is more dependent on how much implant volume to breast volume you have, not necessarily how large the implants are. The picture you posted noting what you do not want to look like shows a patient who likely had very little breast tissue to begin with and most of what you are seeing is implant.
I do think that a sub-glandular augmentation is a good option for you to help with your breast tissue sagging, this often does help patients avoid needing a breast lift right away. This will likely help more with adding upper pole fullness compared to sub-muscular as the top of the implant wont be constantly crushed by the pectoral muscles.
Hope this helps!
-Dr. Halka

Dear melissarn,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

You weren't clear, but if you and your surgeon have decided over the muscle, it won't help. Regardless of over or under, you won't look like your wish pic. Why? Because you don't look like your wish pic before surgery: she had minimal glandular ptosis and you have a lot, and possibly grade I or II ptosis, which will make your outcome different. How will you look? It will look like your implants are too high and your tissue and nipples will hang off the bottom, aka 'waterfall deformity'. With a breast lift, you WILL have your wish pic results. Scars from a breast lift should not be feared, and done by an expert, will be inconspicuous when healed. As for the implant size, if you haven't either used 3D simulation photography or in-office sizing, then it's all guess work (for us and your surgeon), and it may be the wrong size.

Based on your photos you have a 3rd degree ptosis with a moderate lower position of the areola nipple complex, you are way larger than your wish photos and automatically saggier than your example.
So your result with implants will be way saggier than you are now and saggier than your wish photos.
If that is ok for you great. Using a 275 Cc implant your deflated D will increase your size to a smal DDD or large DD and The upper pole will only be slightly rounder.
If this is the type of outcome you are expecting. Great. If not, you are an absolute candidate for a breast lift using a moderate profile implant (180-190cc) under the muscle to achieve natural result ending with a natural large C.
Dr. Cárdenas

It is difficult to give you a good advise and opinion without detailed in person evaluation and discussion about your goals. Implant 275-300 ml. range will give you around 1.5-2 cup sizes up.! Subglandular, over-the-muscle placement, is a good solution. Hope this helps.

Based on the information provided and photos you may want to go under the muscle. This will provide upper pole fullness as well as give a more natural look. With no lift your nipple position will remain essentially as it is now, but the breasts will obviously have more volume. One thing you did not mention but should discuss with your surgeon is the profile of the implant which will contribute to the overall look. I've included a video on implant selection that I hope you find helpful.