Is 450cc low profile gummy bear the right choice? My surgeon isn't telling me. (photos)

It is very difficult to determine if you need a lift or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in a bit.#BA#breastaugmentaion#breastimplant

The breasts may lose their
elasticity and firmness which can be caused by different factors such as
pregnancy, massive weight loss, lactation and aging. To reaffirm the breasts
and restore the natural look your surgeon can perform a mastopexy or breast
lift. A breast lift restores a firmer, perkier, and more
aesthetically pleasing shape to sagging breasts. This not only can improve
a patient’s appearance by restoring her youthful, feminine proportions,
but also help bras and swimsuits fit more comfortably and attractively. By
removing excess, stretched out skin, reshaping the breast tissue, and raising
the nipple & areola into a more forward position, a cosmetic surgeon can create
a more youthful breast contour. Stretched, large areolae can also be
reduced during breast lift surgery, creating an overall better proportioned,
natural looking breast, Actually the perkiness on a person or another, depends
on patients skin and breast tissue for the first 3 to 4
months! 

Thank you for your question and picture. Congrats on your weight loss! Your case is a very complicated one. You need to make sure that you have realistic expectations going into surgery. All of the wish pictures you have posted are women who have had only a breast augmentation and they have a much different starting point than you do. So I would advise that you completely ignore those types of results and just focus on obtaining the best result that you can. With massive weight loss, the skin loses elasticity and support. Often with cases like yours, I would advise proceeding with surgery in two stages. The first stage would be a reduction/lift where the skin is resected and the nipple is lifted to a new position. This can then heal but will leave you with a smaller size, all with the idea that this will change in the second stage. Once you are healed from the lift, you can then try on different sizes and profiles of implants and choose the implants that are right for you. Then at a second stage, you can have implants placed and also a possibility of additional soft tissue support may be required when the implants are placed. This two stage approach will require more surgeries and a longer time period, but will ultimately provide you with a better end result. Without an exam and measurements, it is very hard to speculate, but I would say that my best guess would be that a 450cc low profile implant is not the right implant choice for you. Hope this helps!