Choosing Breast Implant Profiles and Size for Deflated Breasts?

Unfortunately the most commonly used type of implants (high profile) and the most common type of placement ( submuscular/dual plane) cannot deliver the natural 'tear drop' effect that you desire.  There are also big problems associated with anatomic implants placed in conventional planes( they work well in subfascial carefully designed pockets).  This is why I use a very unique methof of breast augmentation that I call 'cold-subfascial augmantation.'  the placement of the implants is not 'above the muscle' or subglandular, nor is it submuscular or dual plane.  A very strong layer of connective tissue is meticulously and atraumatically dissected from the pectoralis major muscle and this tissue is used to shape and support a lower profile implant into a gentle tear drop shape.  It is the surgical dissection and not the implant itself that gives shape to the breasts.  The results sit like natural breasts and do not move like submuscular implants do with arm motion.  The fascia also supports the implant giving it relative protection from gravity and aging.


All the best,


Rian A. Maercks M.D.

It is very difficult to determine the exact size and shape implant you will require to restore your breasts after motherhood 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 the links below:

I use a technique called dimensional breast augmentation which involves taking in a number of factors and measurements, so each patient is unique. That being said, given your height, weight, and your activity level, along with the fact you are considering a lift, I would say you are probably not that far off in choosing an implant in that range. Best thing to do is to see a qualified plastic surgeon that has good breast expertise.Judging by your photo, you may also need a lift to address ptosis. This may be addressed with the allergan 410 style implants.

As much as patients do not want to hear this the changes that have occured in your breasts are not reversible with implants. The tissues have proven that they will stretch and adding volume will only make it worse. I would suggest a lift with or without an implant for improved shape and longer term aesthetic results

If you want the breast to sit higher up on the chest wall, and the nipple to be higher up you will need a lift. For that I would recommend a crescent lift mastopexy. You don't need any more scar than that, because you are adding a lot of volume that will fill up the slack skin. So the only skin you need to remove is that needed to reposition the nipple. The nipple stays attached, of course.
A high profile implant is indicated to add projection and lift the skin in the lower pole of the breast in practically every breast lift.
Check out the video and link below for more info.

Hello - It appears as though you're an excellent candidate for a lift combined with high profile 300-350cc implants. Performing an augmentation without a lift may cause the nipple-areola to "fall" over the implant. The recovery is very straightforward with minimal pain and downtime. Good luck!

In agreement with my colleagues, I would recommend a lift to begin with. Although your existing tissues can be rearranged to minimize volume loss the upper half of the breast will not achieve fullness without the use of an implant. Some view this upper fullness as desireable whereas others believe it creates a "fake" look. That is a matter of opinion and you should express your desires to your Board Certified Plastic Surgeon who will review your options and help select the best implant that will accomplish your goals.

Hi there-
I definitely think you would be best off with a breast lift in conjunction with placement of implants...
With regard to the implant style and shape, it is very important to understand that the best implant for you should be determined based on your current examination and your tissues, and not simply based on your goals for size and shape. This is the "one right result" concept. For help understanding this and why it is so important, please read this:
One of the things I find most interesting is the amount of misinformation the average patient must sift through when researching breast augmentation surgery. In particular, I think that many patients become overwhelmed with implant choices and the abundance of information about these options available on the Web.
This is complicated once they contact a surgeon or two for information about the implants, and which is most likely to give them the result they desire. Somewhere along the way, opinions expressed by a surgeon are perceived as fact by a prospective patient (because of the surgeon's reputation or the apparent strength of his/her opinion), who then becomes more confused when she hears a differing opinion.
This leads to ridiculously technical questions being posted on sites like RealSelf and others, such as:
"I am 5'5", 125 lbs, my measurements are 34, 22, 36. I have had 3 babies, all by C-section, and I breast fed two of them. My breasts sag a little, but not as much as some women I have seen. I want to have a full C-cup breast. Should I get 325 cc Allergan 410 style implants, or Mentor 350 cc Moderate profile implants. Projection is more important to me than a natural shape..."
Every time I get one of these over-thought questions, I always think the same thing... ???????
Let's take a big step back from the trees here and take a look at the forrest in front of us, shall we?
Fundamentally, the reason any woman seeks breast augmentation is because she wants to achieve a certain appearance, right? Let's repeat that- to achieve a certain appearance. NOT a certain bra size, or a certain implant volume, or even a certain implant type. When you first stared to think you might want an augmentation, you didn't think, "I would like it if I could have 350cc implants"... You probably thought, "I would love to look like that (after admiring another woman's breasts)..."
So if we can agree that what you are really after is an appearance you would be happier with (as I always tell my patients), let's make the desired appearance the focus of our communications...Let us both ignore bra sizes (which are not standardized and the choice of which is very arbitrary) and implant types/sizes (for now)... Let's first understand what you want to look like. I think you would agree that if we are able to make you look the way you wanted to look, the letter on your bra and the number on your implant is lees important, right? Help me understand what you want to look like, and I can give you a very accurate recommendation of options for achieving that appearance -- provided a careful physical examination has also occurred.
Why is the exam so critical? After all, can't we just put small implants in women who want small breasts and larger implants into those who want larger ones?
The exam is critical, because for any one particular woman, there are only a few good choices of implants available, regardless of her goals, and these options are arrived at by taking careful stock of her breast tissue, skin, and frame. In other words, your anatomy will, to a large extent, help us understand the implant options that would make you look the best. This is the "One Right Result" concept. The taking of these measurements is so important, I do it myself every time, and based on these measurements and my patient's goals, then make recommendations regarding the implant options available to her (as these options would be different for different women).
While (as with any aesthetic procedure) no guarantee of outcome can be given, you are much more likely to achieve your desired outcome if you focus on communicating your desired appearance successfully with a skilled and experienced, Board Certified Plastic Surgeon than by over-researching the implants and micro-managing the details of the surgery. In fact, I can think of no better way for you to increase the odds of you ending up dissatisfied.
So don't over-think it. Think carefully about the appearance you want, communicate it carefully to your surgeon (using photos if possible), and make sure that the implant choice arrived at by the two of you together is based on both your anatomy and your goal. You'll be happier and the process will be less stressful!

Thank you for sharing your photos.  I would recommend a donut or lollipop shaped breast lift.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.

The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.

I wish you a safe recovery and fantastic result.

Dr. Gill

Hi..................You need a breast lift and for a more natural result, the use of a moderate or moderate plus profile would be most appropriate.  Without the lift, you will have too much tissue in the lower pole and it will not look attractive.  Get the nipple complex to the right position on the breast mound and decrease the surface area of the skin.  This combined with one of the implants mentioned should give you a very nice result.  Discuss these and other options with your ps.   The size implant should be determined by you and your ps but the sizes you mention would probably be in the C cup to full C cup range.  Remember that these comments are based on a picture so your ps can make much more accurate evaluations after seeing you in person.