Breast Implants - how can I achieve this look? (Photos)

Question

Hey doctors, I've attached my friend's pictures (wish pics) and my pics. I want to have - her level of upper pole fullness - that small a gap between the breasts - her level of projection - her height of the breasts, with the top of the breast crease slightly above the armpit I was told a round silicone UHP implant would work, but I've seen UHP results that sink below armpit level/ create a huge gap between breasts. Could I tap on your expertise to ask: how can I achieve this look?

Gary M. Horndeski, MD · Answer

The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. 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 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. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Finny George, MD · Answer

Hi, thank you for sharing your question. You are a great candidate for breast augmentation and will be able to achieve the cleavage and upper pole fullness that your friend has with the upper part of the implants sitting at your desired level. This can be achieved with an ultra high-profile implant. Based on your measurements (which will require an in person visit with a plastic surgeon), you will likely be able to have 400-450cc implants. The ultimate decision on implant size is based on a number of factors and includes the use of sizers during the time of the surgery in order to get the actual implant exactly to your specific anatomy. I hope this helps.

Jules Feledy, Jr., MD · Answer

It is good that you have your friend's results to help guide you. From your photos, you have low breast 'volume' on an otherwise thin/petite body frame. Your base diameter is about 11 cm. It is a question of how to balance shape and breast projection. As a general rule, it takes about 150-175 cc per cup size increase. So, a 350 cc implant would be expected to give you a two cup increase. The shape of the implant is very important here. As you are thin, I think that the UHP dimensions will be a bit severe for your frame. I would look at the HP Xtra implants as they have a slightly wider to projection ratio, and I would make sure that I tried the HPs as well. I cannot see you going below the HP level. 'Test drive' as many implants as you can. I believe that you will be very happy with whatever size you choose. Respectfully, Jules A Feledy, Jr, MD American Board of Plastic Surgery, American Society of Plastic Surgery

Daniel Barrett, MD · Answer

Dear periwinkleskies,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Donald R. Revis Jr, MD · Answer

Good evening,
You are an excellent candidate for augmentation surgery through a crease or nipple incision. We would determine the exact size and profile when I measure your chest, we review photos together, and you have an opportunity to try on the implant sizers here in the office. UHPs might be right for you, but a second option would be the Mentor XHPs- a little more width to fill the gap, and a little silicone overfill to give that nice upper pole fullness. These are the newest implants from Mentor and I have used them several hundred times and patients LOVE them!

Connie Hiers, MD, FACS · Answer

You would do well with implants placed behind the muscle for better upper chest fullness and avoiding seeing the implant edge.  Remember, the implant goes behind the breast and if the breast sits somewhat low on the chest, so will the implant.

Douglas Taranow, DO, FACOS · Answer

You are a very good candidate for a transaxillary silicone breast augmentation.  The Mentor UHP or HPX implants are very good choices.  I use sizers intraoperativly to get the correct size.  I believe s 400-450 would be best.  
Best wishes. 
Dr. Taranow