Asymmetry and sagging - will I be able to achieve my wish pictures? Is over or under the muscle better in my case? (photos)

Question

The first six photos are of me. The last four are my wish pictures. I have asymmetry and sagging. Will I be able to achieve my wish pictures? Any size recommendations implant wise? In my case is over or under the muscle better? Which breast lift incision do you recommend? I want to my breasts to look natural, perkier, and more even.

Harry T. Haramis, MD, FACS · Answer

Best for perkier, fuller breasts would be T lift with implants under muscle. This will allow for better symmetry as well.

Implant size would be determined during consultation with a plastic surgeon as well as to discuss your options and expectations.

Semih Yildiz, MD, FEPOBRAS · Answer

The visible photos show breast asymmetry, ptosis, and a lower nipple position, so an implant alone is unlikely to give a perkier and more even result. A breast lift with implant is more likely to address both shape and volume, but the exact match to wish photos depends on your breast width, skin quality, nipple position, and how much natural tissue you have.

For a natural result, many patients like a moderate-size implant rather than chasing a large volume. A dual-plane or submuscular pocket is often preferred when tissue coverage is limited, but subglandular or subfascial placement can be considered in selected patients with enough soft tissue. Based on the amount of sagging shown, a vertical or anchor-type lift is more predictable than a small periareolar lift; an in-person breast exam and measurements are needed to choose the incision and implant range safely.

Celal Alioglu, MD · Answer

Hello you need breast lifting with implants and implant size will be medium size not too big it needs to be structured of your body

Stephen T. Greenberg, MD, FACS · Answer

Thank you for your question.  Looking at the photos you have provided I would recommend a silicone gel implant under the muscle and a breast lift.  This will allow your surgeon to give you a larger breast, better upper pole firmness and shape. Most importantly a more perkier looking breast.   Under the muscle implants are typically the best way to go.  They uphold very nicely and look/feel much more natural then an above the muscle implant.  I would suggest speaking with a Board Certified Plastic Surgeon in person to evaluate you and discuss your options.  Best of luck to you.

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They then get to choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Ugur Horoz, MD · Answer

hellofor your can plan revision mastopexy and implant change ( with round and bigger implant to give well-rounded shape) with using your last operation incision scars. About the implant plan and size we can better decide during face to face examination. 
best regards

Gerald Minniti, MD, FACS · Answer

With exceedingly few exceptions from expert breast surgeons, placing an implant over the muscle to 'avoid' a lift is just not done anymore. Why? Because it doesn't work well, it doesn't work long, and it leads to excess tissue thinning, implant visibility, and higher risks of capsular contracture. You have asymmetry of size and shape which wouldn't work out well anyway. You need a breast lift and you would get a lovely result.

Shlomo Widder, MD · Answer

Dear Rachel,
    Thanks for posting your pictures and your goal pictures. From observing your pictures your breasts  appear to be small A cup size. from observing your goal pictures they appear to be C or full C cup size. The good news for you is that you can achieve your wish breasts just with mini lift (donut, purse string lift) and saline implants  where the scars are only around the areola and avoid the vertical scar. The saline implants will help to achieve more symmetry and nicer cleavage.
    In order to recommend for you  the implants' size I will need to know your chest circumference in inches. If you are currently 32 small A cup size, to become 32 full C , you will need implants filled with 375 cc saline. For 34 full C - 450 cc saline. Due to the asymmetry of your breasts you will need  25-50 cc of saline added to the right breast to achieve more symmetry.
   Always, consult with experience board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery to make sure that they are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.
                       Best of luck,
                                        Dr Widder
                                  widderplasticsurgery.com

Finny George, MD · Answer

Hi, thank you for sharing your question. You are a great candidate for breast augmentation. Based on the photos, you will be able to achieve your goal result. You can opt for above or below the muscle but a dual plane may be ideal. I hope this helps.

Asymmetry and sagging - will I be able to achieve my wish pictures? Is over or under the muscle better in my case? (photos)

Answers (18)

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