Larger Breast Implant to Create Upper Pole Fullness and Cleavage?

The doctor said that my tissue and skin are the culprits, not able to hold the implants up. I am 128 lbs. 5'4 and before surgery between B and C cup.

Doctor Answers 12

Upper pole Fullness with Breasts Implants?

Thank you for the question.

It sounds like you made benefit from additional support in the lower poles  of the breasts  to allow for implants to remain in good position and achieve the upper pole fullness that you are looking for. This procedure involves permanent sutures along the lower poles of the breasts ( inferior capsulorraphy)  that serve to support the breast implant positioning  and help prevent  recurrent downward movement of the implants.

It would be in your best interest to seek consultation with a board-certified plastic surgeon experienced In revisionary breast surgery.

 Hope this helps.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,501 reviews

You have to careful in this situation

The most important thing to realize is that everybody's shape, size, and skin elasticity is different. You should see more than one surgeon for an opinion on your case because achieving a great result can be difficult. You can tell by the variety of answers for this question that there may not be one perfect answer. The answer that I give people in emails is that I do any of those procedures necessary to give the best result possible. high profile implant may do the trick, but if the implant becomes too big, it can certainly fall with time. A lift may be needed, either periareolar or a more traditional skin excision, but that has to be determined on exam. See several reputable surgeons and try to get a consensus on what would be the best procedure for you. Good luck.

Shain A. Cuber, MD
Edison Plastic Surgeon
4.7 out of 5 stars 86 reviews

Elusive upper pole fullness!!

The upper pole is the area of the chest between the collar bone and the nipple. We've been thoroughly brainwashed by the lingerie companies that it should be full and heaving, even when we're not wearing push up bras. The difficulty with keeping the upper pole full with a larger volume implant is the fact that gravity and time will eventually cause the implant to settle to a lower and often more lateral (external) position. While a larger volume and a higher profile round implant may initially seem to solve the problem of an empty upper pole, most surgeons will agree that it will eventually sag and commit you to revisional surgery, which could take the form of a breast lift, exchange for textured implants, (which tend to displace less) and/or placement of an internal sling (Alloderm, Strattice, Neoform, Flex HD, etc.). Either way, it's an expensive proposition and you also run the risk of being extremely disappointed.

The only way that implants rise into the upper pole, that I have seen, is when the force of the capsule (or scar tissue) compresses on the implant sufficiently, to cause a "hammock" effect. Increasing degrees of capsular contracture or thickness around a breast implant are generally accompanied by discomfort as well as distortion of the shape of the breast.

Engage in a dialogue with your consultant. Tell him/her what your aesthetic objectives are but also put some credence in his/her observations on the quality of your tissues and their ability to "hold" a given implant size. Good luck.

Lavinia K. Chong, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 58 reviews

Upper pole fullness is difficult to get

Sometimes it can be achieved with a breast augmentation alone, but not necessarily just by putting in larger implants. You may be a candidate for a lift which would also help create some fullness in the upper pole. Also, placing implants above the muscle can help increase upper pole fullness. A larger implant may not be the answer for you and it really depends on what your breasts look like and what your skin feels like. Good luck.

Sirish Maddali, MD
Portland Plastic Surgeon
2.0 out of 5 stars 1 review

Stick to your breast augmentation goals

  • You want "perky"
  • You want fullness in the upper pole
  • You don't want to be bigger

A high profile implant may give you a lot of what you want. A high profile implant will appear perkier. Because of its steeper angle of takeoff from the chest wall, it will give you more definition at the upper pole.

Secondly, the implant can be placed higher on the chest wall by modifying the capsule of the breast at the lower pole.

Without seeing the scars, I cannot comment on them.

In general, i find the problem with breast lift and augmentation is that you have to be careful with how much skin you take out. Taking off skin is good for just a lift, since you are tightening the skin envelope.

The moment you insert an implant, there is hardly a need to excise tissue, since the implant itself takes up the slack. The only thing you need is to lift the nipple.

That is why on most lift/augmentations the most you need is a crescent lift or at most a circumareolar (all around the areola) incision.

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 94 reviews

Larger implants are rarely the proper solution

If your comment is in response to your unhappiness with the results of an augmentation surgery, you may have benefitted from some form of breast lift in addition to an augmentation. It is also vitally important to assess the quality of your tissues when chosing an implant size. You may have also been someone who would have benefitted from a textured implant although I rarely use them personally. I wish you well.

Dr Edwards

Michael C. Edwards, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 35 reviews

There are alternatives

Upper pole fullness usually can be restored by a revision surgery in which the pocket is modified and a re excision of skin is performed. Larger implants have the disadvantage of adding weight to the already stretched out breast envelope. I would only consider larger implants if you wanted to be a larger cup size. Consult with a Plastic Surgeon who has extensive experience in breast surgery.

Robert M. Jensen, MD
Medford Plastic Surgeon
4.8 out of 5 stars 42 reviews

Not necessarily "larger"

Dear Scarlett,

In 2009, we have the capability of measuring your body size and tissues before deciding on the type and size of implant necessary for your individual needs. This technique of biodimensional planning has enabled us, as plastic surgeons, to finely tailor the implant needs of the patient to their body type. You may be able to keep the same volume implant, but change its diameter to improve your cleavage and upper pole fullness. You would compromise some projection with this plan, but it might avoid the issues referred to by my colleagues with implant dropping and stretching tissues. Good luck!


Kenneth R. Francis, MD, FACS
Manhattan Plastic Surgeon
4.6 out of 5 stars 48 reviews

Heaver implants do cause more stress on the skin.

It is possible to have larger implants to create more upper pole fullness and cleavage. However, you also need to realize that the heavier the implant, the more stress there is on the skin and tissues which can cause them to stretch. If you post pictures, we may be able to give you more specific advice. Good luck.

David Shafer, MD
New York Plastic Surgeon
4.9 out of 5 stars 77 reviews

Larger implants can improve upper fullness

Breast implants in augmentation do provide upper fullness which is lost after multiple pregnancies. Often patients are not necessarily interested in an increased cup size, though universally the upper scoop in the breast with loss of projection is a key complaint. Breast lift or mastopexy is very effective in correction of the nipple location relative to the fold under the breast, however upper fill and firmness are best provided by addition of an implant to the breast, in either a submuscular, or a subglandular location.

Implant volumes are determined by the base diameter of the implant and by the projection of the implant, and a balance between the two will determine the overall "look" of the breast. When skin is loose I prefer a subglandular silicone gel implant with a sufficient base diameter to match the size of the natural breast. Centered on the gland and nipple, the implant will adequately fill the upper pole and contribute to the lift, pertness and firmness of the breast. If a larger implant is acceptable, you can increase the size and see an improvement in the upper fill and cleavage of your breast.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 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.