What type and size of breast implant should I get?

you have lost breast volume and have breast ptosis. Altough breast augmentation with breast implants will help to replenish your lost breast volume, you would also need a breast lift. Unfortunately, from your pictures, without an examination it is not possible to tell you what type of breast lift you will need.

It is very common that women have asymmetrical breasts prior to their augmentation. With the use of different size implants the volume difference will help decrease the difference between your two breasts.

In terms of a breast lift I would do a periareolar lift, which goes around the areola and typically hides very well at the junction of the areola and the normal breast skin. This would allow me to set you nipple at the same level giving the appearance of symmetry.

The good news is that lots of women come to the office with asymmetrical breasts such as yourself and they are very happy with their results.

It's difficult to say if you need a lift with your augmentation based on your photos. Your nipple position is on the border and your arms are elevated with raise them to some degree. So a consultation is necessary to give you more information. I hope that's helpful. 

You appear to be a typical "borderline' case which can go either way with respect to your choice of breast enhancement procedure depending on your preference and expectation of your desired surgical outcome.

If you are prepared to accept your relative "low breasted" position on your chest and a reasonably sized breast implants in filling your deflated breast skin envelope post pregnancy, then I think you could achieve a very nice, natural, proportional result without any scars on your breast mounds. However, if you really desire for the "footprints" of your breasts to sit higher in your chest, then you'll require a lift and a moderate sized implants in order to allow the optimal tightening of your breast skin envelope and lifting of your breast & nipple areolar positions. A concurrent breast lift in addition to breast implants will also enable an appropriate proportional reshaping of your nipple areolar complex in achieving a more elegant and perky result with reference to your new breast dimensions and body frame configuration. The down sides of breast augmentation lift procedure would obviously involve additional scars on breast mounds, a more complex surgical procedure with more elaborate post op recovery and financial costs.

It's important to weigh all the clinical and logistics tradeoffs & limitations before deciding on the appropriate procedure that is right for you. I highly recommend you to seek a proper in person consultation with a thorough clinical assessment from a fully qualified specialist plastic surgeon for further in depth advice.

Hope that helps.

Best wishes

Ellis Choy

Implant size is a personal decision. I use sizers in the operating room to assist with the decision making. Don't be too conservative, many patients wish they went to a larger size after surgery.

Thank you for your pictures.  There is a very good chance, depending on the size you would like to be, that a breast lift (i.e. repositioning the nipple) may not be required.  You issue is deflation, not really descent of your breast.  Adding volume with a silicone implant, particularly if you desire a C cup or larger will most likely raise the nipple to a very nice position.  If you did need a lift (at most a very small one), particular after a few months, this could always be performed in the office setting through a circular incision...this should be fairly minimal cost.  i would choose the implant alone.

A combination procedure using a breast implant and a lift will give you the result you are looking for. Either operation alone would be suboptimal.
The implant is necessary to restore lost volume but also to add volume to the upper pole of the breast to restore the youthful appearance you mentioned.
The breast lift will place the nipple areola over the most projecting point of the breast and elevate the lower pole off your chest wall.
As far as the asymmetry is concerned, this operation will make the breasts more similar but I would not expect them to be exactly the same. Using the same implants and altering the breast tissue and skin to achieve symmetry has worked very well for me in situations like this.
I would be very optimistic about the improvement you will obtain in the hands of an experienced plastic surgeon.

Thanks for asking the questions. The photographs do show lack of breast tissue in upper pole and drooping of nipple areola complex. This condition will benefit from augmentation with implants and uplift of the nipple areola complex to achieve pleasing results. Based on expectation of perkiness and upper pole fullness, different implants can be tried as sizer to find the correct implant give the desired results. In such cases, implants are generally placed behind the muscle and implants might lose a degree of its projection. The implant selection should suit the frame and should be tailored to the patient to meet the expectations. The implants with softer gel, the ergonomics can be a good option for achieving natural look in the upper pole. Please see a plastic surgeon to discuss and look at all options for your surgery

Then you for posting with your photo and information. But you left out something I feel is most important.... the size you would like to be after surgery. A good guess would be around 300cc. An in-person evaluation with specific measurements and the use of sizers will help you decide on the perfect size.If you want them sitting higher and more symmetrical you will need to have a lift. The lift will help with symmetry.Best of luck!Dr. Miguel Mota.

With a single front image, it is challenging to be able to provide much advice. It is common in our practice to do a breast lift with an implant to provide the shape that patients are looking for. An implant alone might not really help you achieve the "perky" look that many people are thinking of as an end goal. It would be good to do a little research and find board certified plastic surgeons in your area with before and after photos, and who also have vectra 3d imaging software so you can see what different implant sizes would like like on your own frame.

I appreciate your question!

After performing hundreds of breast augmentations, I have found that the size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision. Bringing photos as well can help us to finalize, but please understand that these are of other people’s bodies and your results will probably be different.

Silicone will give you fullness at the top (upper pole fullness). Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a softer silicone (less cross-linked), if this implant should rupture, it may leak but only into the scar capsule formed. However, the newer silicone in these implants may not leak even when the implant shell is ruptured.

Anatomic gummy bear implants might be a good choice to give you a more natural look. These highly sought after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, is a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers. I also use a 3D imaging system to allow you to try on a variety of shapes and sizes. I prefer this method over adding volume due to implants being under the muscle.

We will also discuss the possibility of needing a lift along with an implant. This will depend on the amount of ptosis (nipple position) as it relates to your breast, inframammary crease and chest wall. Needing a lift or not will also determine where to place the scar for the incision.  In some cases if the breast and nipple is really ptotic (low) it might be best to stage the procedure by performing a lift first and then doing an implant at a second stage. This will also allow you to have a better understanding of the true size and shape of your breast.

The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon 

#RealSelf100Surgeon

#RealSelfCORESurgeon