Choosing Breast Implant Profiles and Size for Deflated Breasts?

My breasts are deflated after nursing and I want to be informed for my consultations. I am 5'6", 150 lbs, have a 34-36 inch chest, roughly 13 BWD and want to fill out my breasts without going too big.

I describe it as wanting my money's worth and preferring the larger size of natural looking without looking obviously fake.

Based on my photos, what style of implant will work best (mod plus or high profile?), approx size (350cc-400cc, maybe bigger?) and does it seem like I need some kind of lift? Thanks.

Doctor Answers 20

Deflated Breasts Best Treated with SAM Breast Lift and Moderate Profile Plus Implants

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Thank you for your question.

You will get the best result with a combination SAM (Simultaneous Augmentation Mastopexy) Breast Lift and Moderate Profile Plus Breast Implants. High Profile and Shaped Breast Implants will not give you as natural looking result.

Please see the blog in the link below

Natural appearing large implants

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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.

Treating the deflated breast

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First of all, you clearly need a breast lift because of excess lower pole skin laxity. This is like a loose hammock which will continue to sag unless it is tightened.

Second, the implant for a "natural" look is not the HP, but the moderate. The moderate plus has some extra upper inner pole fullness but not to excessive. The implant should match your base dimension. Remember that with your breast lifted up onto the implant and with the skin tightened, you don't need as much volume as you might imagine.

Check my gallery for examples.

Breast implant sizing

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From your photos, you may need to have a breast lift as well as implants.   

Much of the final “look” achieved after breast augmentation surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.
3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon.  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 “C cup” or "fake looking" 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.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.

Breast augmentation and lift

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It looks like you will ned a lift and an augmentation. As for the berst sized implants, it is hard to say without a formal exam.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Augmentation for a deflated breast

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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.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 98 reviews

Deflated breasts can regain volume and shape with a lift and implant

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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!

Breast lift and augmentation

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A side view would be better to get an idea of the amount of sagging you have, but it appears as if you will need some sort of a lift. With a lift, a surgeon can idealized your shape and form and then determine the appropriate size implant to use. He can probably use some tape to give you an idea of what the lift might look like and then perform measurements to get an idea of dimensions.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Breast Implant considerations for deflated breasts

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I agree, you need a lift with or without a small saline high profile implant. Go see 3 boarded plastic surgeons in your area to iscuss with them your options. Regards. 

Deciding on the best breast operation for you: Breast Lift and/or Implants

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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.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.