Perkier breasts- lift or implant?
My strong preference in patients who want perkier breasts but are OK with their current size is to have a nicely done breast lift.
Patients who need extra upper pole fullness may require an implant as well, but I usually try to talk patients out of this since natural breasts require much less maintenance than breasts with implants. However it is ultimately the choice of the patient.
Breast lift with implants?
I think you may end up most pleased with the results of surgery after a breast lift and a “small” sub muscular breast.
Having said that, the more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size. This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone and low/moderate/high profile), bra manufacturer variance in cup sizes, the degree of filling of the cup with breast tissue, and the subjective differences in patients perceptions of cup size.
Much of the final “look” achieved after breast augmentation surgery depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone) or model (low/moderate/high profile) of implant.
3. The type of implant used may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have. If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants. If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference. Patients may need an MRI to diagnose a silicone gel rupture. Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may make a significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" or "top heavy" or "perky" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.
Perkier breasts with adding size
I have spoken with many women who have your same concerns: they want perkier breasts, but don't want to be bigger. And, quite simply, if you don't want to be bigger, don't want to have implants. Implants add volume to the breasts and, by necessity, will make your breasts bigger. So, if you are OK with your size, or even want to be a little smaller, you don't want implants.
Now, many women have been lead to believe that you need to have implants if you want perkier breasts. And this is just not so. From looking at your photo (and you are very kind to include this) you can get a very nice result with a breast lift alone. The breast can be reshaped, lifted, and be made more perky. Your anatomy is really perfect for a breast lift, or even a breast lift with the removal of a small amount of tissue.
Bottom line: have your breasts lifted. As you are happy with you size, don't add to it!
Best of luck,
From your pictures, what you need is a mastopexy or lift. This needs to be a full lift with release of the breast tissue to allow it to move up and fill the superior part of the breast.
Since you do not want to be any larger, and perhaps even a little smaller, you definitely do not want to have an implant, even a small one. No matter how small the implant, it will increase the size of your breasts.
Breast implants not necessary for lift
Anytime you add implannts to the breasts your breasts will get bigger, unless you are also removing breast tissue of equal or greater volume. If you do not want to go bigger you should not have implants.
In fact it is much easier to do just a breast lift with no implants and the recurrence rate of drooping is less without the implants. You should be able to get the fullness you want without implants.
Perky without bigger breasts
Since you seem to focus on perkiness, define exactly what you mean by that. Is it s shape? Is it the location of the nipple? Is it the amount of hanging under the fold? Is it firmness of the breast tissues? I suspect that a mastopexy of sorts (there are many variations) would get you most of what you want. If not, a small implant might also help but this would make you bigger to some extent and you would have to accept all the risks of having the implant.
Lift alone may impact fullness.
It’s not unusual for women to
lose breast volume and develop breast sag following pregnancy and normal
aging.These changes adversely impact
self-esteem and self-image and for this reason, many women request cosmetic breast
Your pictures suggest that you would definitely benefit
from a full, anchor-type keyhole breast lift.This approach is required to address excess skin in both the transverse
and vertical dimensions.Breast lift
surgery alone may provide enough upper breast fullness to make your breasts
look perky and achieve your aesthetic goals, but if upper breast fullness is
inadequate, a small implant may be necessary.Unfortunately, there’s no way to add an implant and not make your
If you’re considering breast lift surgery, consultation
with a board certified plastic surgeon is appropriate.This surgeon should be able to formulate a
treatment plan that addresses your anatomic findings and achieves your
Implants are going to increase your volume no matter what. So if you are wanting to maintain current breast size or even reduce your breast size, I would not recommend an implant. It is possible to get some fullness and perkiness to the breast with just a lift. It's just a matter of talking with your surgeon and having a realistic expectation of the outcome without implants.
Breast lift and implants without going bigger
Once you add an implant, no matter how small, your breasts are now bigger because you have added additional volume to your breasts. The implant will add upper pole fullness to your breasts, but you will definately have larger breasts. If you have a lift alone, you can re-position your breasts to a higher position, and maintain your current volume. If you want to be smaller than you currently are, you may want to consider a small breast reduction, either with or without implants. You should consult with an experienced breast surgeon to discuss your desires and evaluate your options. Good luck!
What breast lifts and breast implants do
Breast lift (mastopexy), properly done, repositions the breast higher up on the chest. It does not fill in the upper chest or give projection. It does not give "perkiness" in the sense of filled out or forward fill. It also makes the breast look bigger but doesn't actually make it bigger. The scars involved are also much more extensive than for an augmentation.
Implants are like pillows -- volume and fill only. Implants fill in the upper pole of the breast and give it forward fill if they are not too low which makes it more "perky" looking but doesn't actually lift or raise the nipple-areola or breast itself. The minimum size increase with properly fitted round saline or gel implants (assuming the breast is not too sagged already) is one cup size.
In my experience, thinking a lift or implant is going to do something that it isn't going to do and can't do is a set up for disappointment and secondary operations.