Breast Implant size - lift or not? (photos)

An examination in person is obviously required to properly evaluate you and make appropriate treatment recommendations. That said, your plastic surgeon has the advantage of having examined you and his or her recommendations are based on that examination measurements so far be it for any of us to disagree. However, your photos show that you appear to have relatively low set breasts on your chest, even though your nipples re not particularly low in relation to your breast.

If you do not undergo an augmentation mastopexy, I would take issue with the recommendation for a sub pectoral or dual plane augmentation since this can easily lead to a "waterfall" deformity wherein your implants are high and your breast is low, with a resulting oval rather than round shape to the breasts. You can look fine in clothing, bra or bathing suit, but not in the nude. Therefore, I would recommend a subfascial implant placement and leave your pectoral muscle undisturbed.

With regard to the size implant you should have, the most important criterion is width. The final look you wish to have will determine which implant would be best, but almost always I recommend a Moderate or Moderate Plus profile since a High Profile Implant would most likely be too large a volume for the diameter you would require. You are correct that 500 cc is considered very large for augmentation in my own practice, where the most common size implant is 275-350 cc, resulting in a very natural appearance, which most of my patients desire.

Please use photos of "favorites" to communicate with your plastic surgeon as to your desired endpoint, and if you feel uncomfortable with the size recommendations from your initial consultation, I recommend a follow up visit with your plastic surgeon, or a second opinion. Remember, there is not always one solution. Best of luck to you.

Hello @beck108 Thank you for your question and showing your pictures. If you going to have a breast surgery a suggest a lift or a lift with prostheses because just getting big implants won't solve that the breast is sagging. For the most adequate aesthetic result over time what we want is to raise it and rearrange it, to put it in its place, so that the projection of the breast from the anterior axillary line to the external midline and give it projection. The best course of action is to consult one or several board certified plastic surgeon for more information and options tailored specifically to your needs. Best wishes! Alan Gonzalez MD FACS

Hi, thank you for sharing your question. You have glandular ptosis which means that a significant amount of breast tissue is positioned lower that ideal. Implant alone may worsen this appearance over time. I would recommend a breast lift and implants. The size of the implants should also carefully be decided to avoid complications. I hope this helps.

You do have some degree of ptosis (or droop) to your breasts at this point. It is likely adding the implant will exaggerate that degree of droop. I would recommend the lift to increase the longevity of your result.

Thanks for your question! I think the answer really depends on your goals. I would suggest taking B&A photos of patients that you like to your surgeon and getting his opinion. That can help guide the conversation. Good luck!

If you are truly concerned about the appearance of your breasts 10 years from now, having a lift with a smaller implant would be the better option. I suspect a 500cc implant will take you beyond your desired volume and the added weight will likely accelerate the otherwise gradual sagging to your breasts. Discuss you options further and inform your surgeon about your concern regarding appearance in 10 years.

The technique I recommend is a lift using 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 can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Thanks for the question and providing the photographs. I agree that using higher profile implants can give you some lift but generally it doesn't address any excess skin in lower pole. At the same time bigger the implant , higher the chances of drooping of tissues over time. you can consider using mesh like Galaflex to provide internal support. An uplift at the same time as augmentation can give a good results with moving the nipple slightly higher and removing excess skin in lower pole. Your surgeon can discuss these in detail after detailed examination and measurements.

Breast may only look different in the future after significant weight change or the milk of pregnancy. 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

Borderline cases can avoid lift with larger implants. Dual plane or totally above the muscle can give more “lift” effect in some patients.

Without formal lift and scars, your breasts will be fuller but remain in their current position. Many women will favor this over formal mastopexy scars.

If you want high and perky breasts, then a lift with implants should be considered.

Further discussion with your plastic surgeon is recommended so you feel comfortable.

This depends on your goals. If you want to be functional, most patients go with a more conservative size. If that means a lift, then patients tend to choose that. I have 3D Vectra imaging software in my office to facilitate these discussions so you may want to ask if they have something like that to help.