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.

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.

Please do not try and avoid getting a lift by getting large heavy implants. They will just sag more over time. You do need a lift because you have sagging breast tissue. Please choose an appropriate size for your frame and tissue and do the lift. You will be much happier in the long run.