In my opinion, the last thing you need are breast implants. You demonstrate significant breast sagging with asymmetrical large breasts. The ideal operation for you would be a short scar vertical breast lift (Mastopexy). The procedure would render the breasts perkier and fuller, reduce the difference between them and correct the sagging.
Adding breast implants will NOT lift the breasts but surely worsen the asymmetry and hasten the sagging. A periareolar breast lift is too limited to correct your situation.
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Dr. P. Aldea
Breast implants and the tear-drop shape
Within the breast there are natural ligaments which control the shape and flow of the breast giving it a tear-drop shape as seen when standing in front of a mirror. The shape or personality of the breast as I sometimes call it is also influenced by the volume and weight of the breast, the laxity of the skin, and the position of the nipple. As you can try yourself at home, the breast shape will flow and shift as you change position.
As you lie down the breast moves up and to the side. On your side the tear-drop moves sideways and the upper breast falls inward to produce cleavage. In a headstand . . . you get the idea.
Breast augmentation should enhance the natural personality of the breast, and flow and move with the breast in a natural way. The implant in the best of situations should flex and shift shape with gravity just like the breast. I know there is interest in the 410 for breast augmentation, but the stable form of the implant will look natural in one position only. Special situations may call for this compromise, and I know others have opinions that differ, but the 410 for augmentation? Consider carefully before choosing.
Best of luck.
Vertical Breast Lift with Low profile implants
You would be a good candidate for a vertical breast lift with a dermal pedicle autoaugmetnation. If you desire to be a larger breast size then an implant would be appropriate. I would consider a low profile implant to fill out the base diameter of the your breast in the 300 to 400 cc range
While I do not think a circumareola lift would get you the lift you want, I can not tell from this solitary photos for sure. I am not a big fan of the tear drop shaped implants.
Understanding the need for a breast lift
These photos appear to show a large D. A few things to keep in mind: With a periareolar elliptical incision you could realistically expect 1/2" to 1" of breast lifting. A small implant, 350-400cc will give you enlargement only.
And for something you could try on your own, measure from your mid clavicle to your nipple. If the measurement is greater than 24-25cm, then you will need a conventional lift to get the results you're hoping for.
Avoid the Doughnut Breast Lift
I am sorry to pick on you, but I think that we need to be honest with each other.
- You may be overweight. It's difficult to "size" breast implants in bigger gals, especially if they are young and their weight might continue to fluctuate.
- Your breasts already appear pretty big. Do you really want implants to make them even bigger?
- Your asymmetry is significant. The breasts are not only different sizes, but they are shaped differently.
- Periareolar breast lifts (also known as Benelli mastopexies or dough-nut mastopexies) flatten breasts. Periareolar lifts do just the opposite of what you want; you will not get tear-drop shapes.
Truthfully, some sort of lollipop lift or inverted-T lift would probably be your best bet. Scars seem distasteful before surgery, but most post-operative patients are not bothered.
Periareolar breast lift techniques are for a very small group of women...
I always advise patients to NOT choose an operation because it is associated with the scar they think they want...
Think of it this way- if after surgery your breasts are funny looking, but you have the cute scar you wanted, will you be happy? I doubt it.
Much better to have breasts that are beautiful AND have an acceptable scar (and yes this is possible).
Periareolar lifts tend to do two very unfavorable things in women with breasts shaped like yours- they cause stretching of the nipples, and a flattening of the central breast mound.
I would recommend that you find a surgeon certified by The American Board of Plastic Surgery who has a LOT of experience doing breast surgery and follow their recommendations.
There are a lot of goofy looking breasts out there- don't let yours become weird too.
How to find a surgeon you like and can trust? Read this:
Numeoous issues with limited breast lift in large breasted individual
A 400 cc implant will easily take you up 2 cup sizes if not more. With that size of an implant you will still retain your tear drop shape. Doing a periareolar lift will do nothing to change the shape of your breast, it will simply reposition the nipple on the breast mound. I predict the main problem will be that you will not like the appearance of your breast within the next 5 years as they will continue to sag due to their size.
Breast Lift and Implant for a teardrop breast
Most patients who choose their operation in relation to what they think they "might" need are often disappointed. You surgery should be based upon what your anatomy dictates in light of your end desire. It appears that you have, like most women, a small asymmetry and sagging breasts that will need more than just a peri-areolar lift to look like you'd prefer.
The majority of women want a natural, "tear-drop" shape to the breast, but also want some degree of fullness on the upper aspect of the breast. This can be achieved in a number of ways with the most subtle being an "internal" type lift which will subtly increase your fullness, to adding an implant which will definitely increase your upper pole fullness. This can be controlled by the "profile" of the implant used. 34FF breasts likely will need a combination of both reduction and augmentation to "redistribute" the breast/implant volume from primarily at the bottom, to more balanced throughout.
Finally, you must consent to some degree of a more aggressive lift (vertical) to restore a more youthful appearance to your breasts. Best of luck.
You may need a full breast lift
I will tender my opinion here. I think you need a full lift, not the peri-areolar. Just too much to accomplish without the full lift. Plus, the areolas stretch out witht the peri type.
With a lift, you will tend to see smaller breasts, so an implant will be needed to end up larger. Again, my opinion, the tear drop shaped implants do not give as perky a result as the round, and the reps say that it is for the "mature" breast and reconstruction. I would look at the round type of implants just to be sure.