Can 500cc Breast Implants with Lift Give a Natural Shape?

Breast augmentation and mastopexy (breast lift) together can be an extremely complex operation with a high rate of revision and complications.  The larger you go with an implant when you're also doing a breast lift at the same time can add tension to the incisions and increase risk for skin necrosis, wound breakdown, and most importantly even threaten the circulation to the nipple.  Also with a large implant and lift there is a much higher chance of getting a superior malposition of the implant which is also known as a "high riding implant" because the implant isn't massaged as frequently (because it can risk the scars separating from the lift).  If you want to go that big, either do it in two steps and do the lift later, or do a more modest size implant with the lift and when everything heals, you can come back and do an "exchange of implants" which is a simple outpatient procedure.  Finally, there is one more option that we pioneered in our practice which is called "delayed fill" which is placing a saline implant partially filled at the time of the lift, and then adding the rest of the fluid into the implant several weeks later in the office.  I hope this helps!

Sincerely,

James F. Boynton, M.D., F.A.C.S.

In order to make accurate recommendation, I would need to examine the breast mound and chest wall with several measurements.

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

In massive weight loss patients,  the base width or diameter of the breast is often much greater than a patient of average build who has not undergone the same drastic changes in body shape.  For most of my massive weight loss patients,  a 500 cc implant is not too large for their chest.  This is well documented in the massive weight loss literature. Plastic surgeons who do not perfrom a lot of post gastric bypass surgery often underestimate the importance of this fact.  That said - an "Angelina Jolie" breast is probably a very unrealistic goal - you should have another talk with your surgeon prior to your surgery about your goals for the surgery.

Hi.

Of course, everybody's anatomy is different, and I haven't examined you. But in New York City, we almost never use 500 cc breast implants. And together with a breast lift, there is an even higher risk of problems. Try to find a surgeon who does a "spiral" mastopexy.

Every person looks a bit different with implants. It is hard to predict how you would look without examining you. In a patient witha a large amount of weight loss, I imagine you have alot of loose breast skin of poor quality. Going with a fairly large implant may cause the breasts to sag sooner than a smaller implant.

Maybe.

The problem is that MOST no-plastic surgeons commonly equate "natural" with attractive and healthy when, in fact, natural often means found in nature or copying nature. ( As such, droopy breasts, wrinkled faces are truly "natural").

Along those lines, allow me to express my sincerest skepticism as regards the veracity of the unaided "naturalness" of the "Angelina Jolie-type breast shape" in most women, including the actress, and I would like you to imagine just how attractive her present breasts will be in 20 years or less, when they inevitably lose their eternal battle with gravity and head south. (I believe the descriptive word is avalanche,,)

Seriously. For cosmetic surgery to work well, plastic surgeons have to recognize obstacles and pitfalls as well as each patient's particular terrain requirements and navigate them based on BOTH common sense and surgical experience.

YOUR current breast skin envelope may allow your surgeon to place an 800 cc implant in you - but that does not mean that he/she should do so.

Your present breast tissue (inside the skin envelope) will dictate how much COVER it can provide an implant (to make its ripples less obvious). As such if you had a huge breast skin envelope and only a small amount of breast tissue you would require a breast lift to remove extra skin and either have a smaller implant, an implant that ripples less (gel) OR extra cover to an implant such as can be provided with loose tissue on the sides of the breasts used as a filler flap or even a back muscle flap on top of a larger (now covered) implant.

There is a world of possibilities out there. Each one of which has its draw backs. When you understand them, THE choice will become much clearer.

But - if I can leave you with one simple thought to keep repeating to yourself - Bigger is NOT always better and 500 cc is NOT small.

I hope this was helpful.

This really depends on you body shape and skin quality. If you do have a wide chest diameter along with widely shaped breasts, then large breast implants can still give a natural look. It is hard to say whether 500cc is right for you without examining you personally. A second point is that it is difficult to do an augmentation procedure and a lift at the same time. Many surgeons would advice you perform the lift first, then augment several months later. Make sure you are going to qualified plastic surgeons for your consultation and good luck with your procedure.

500cc should be fine as long as you have a general idea of how this is going to look afterward. Look at pictures of women who have had 500cc implants and see if this is the look that you want. Further, you can place sample implants in your bra to get a general idea of how you're going to look afterward. A lift is also very commonly used with an implant after massive weight loss to help lift the areola. Only a small amount of lift is acheived with just an implant, so a lift is commonly used simultaneously. Most women who lose a lot of weight have significant drooping of the areolae and need a formal lift. Good luck!

Congratulation on the massive weight loss. As you experienced, there was significant volume loss from the breasts. This usually leaves a loose skin envelope, the skin tends to have a lot of stretch marks, it is thin with loss of elasticity. If this is the case, placing a 500cc implant will result in further stretching and sagging. Even if you have a lift at the same time, you van experience fairly early descent. Without the benefit of photos, I would suggest having a breast lift first, and have an augmentation about 6-12 months later. This way you will have potentially fewer reoperations, and more natural looking breasts. You need to discuss this with a plastic surgeon with experience in massive weight loss surgery. For examples, please visit my web site: www.bellevueplasticsurgeons.com.

These questions are very difficult to answer since there are so many variables. 500cc is what I would consider the larger end of the spectrum but if you have a large frame it could work out well for you. Types of implants, placement of implants, and the surgical technique can all influence the final appearance and "naturalness". Having lost 150 pounds suggests you have a fairly large frame. Wanting to look like Angelina Jolie sounds a little unrealistic. I am fairly certain she never lost 150 pounds.