What would be best for my shape? Would I need a lift? Am I good candidate for larger implants? (Photo)

I am going to get BA in March of next year. I know I want large implants somewhere between 700-800cc's. I can't decide on HP or Mod+. I have a large frame and my breast have already stretched due to breastfeeding. What would be best for my shape? Would I need a lift?

Doctor Answers 13

Breast lift or not

It specifically depends on your goals.  Just judging from you pictures, it seems that you will need a lift to have an aesthetically pleasing outcome.  However, the best plan is to find a board-certified plastic surgeon and discuss your goals with him/her.  They will be able to guide you.  Good luck.

Austin Plastic Surgeon
5.0 out of 5 stars 84 reviews

Lift and Fill - #BreastLift/ImplantChoice

Regarding the lift, I would recommend it if you want to look perky as you have significant sagging. Regarding the size, you need to leave that to an expert after you share what you want to look like. It is very difficult to determine 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 the below link.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews

You need evaluation before deciding on breast implant size

Whoa! You already decided you want 700 to 800 cc? That might not fit depending on the measurements of the width of the breast. Breast augmentation is not snapping new breasts on the outside but putting an implant in your skin envelope. You will need to meet with surgeon(s) with experience to determine if that is possible.

You have a narrow breast and a fair amount of droop.
An examination will be necessary to determine if you need a lift and what size of implant.

A large implant and a lift together at the same operation has a very high complication rate and high revision.

Just by your pictures my guess is you would either need a lift first, and then a second operation later to place that large of an implant. The lift is a tightening operation; and the augmentation, with a large implant, an expanding operation, and they fight each other. I would recommend two stages for the best result with the least complications.

The other option might be to place the implant subfascial, below the gland but above the muscle. The large implant might correct some of the droop. If you dont mind a mature looking breast that might be an option depending on the nipple to sternal measurement.  A mini lift with the subfascial implant is another option.
The subfascial approach might allow the implant size you want. I have done that for situations such as yours.

Benjamin Van Raalte, MD
Davenport Plastic Surgeon
4.7 out of 5 stars 42 reviews

Large Breast Implants and Breast Lift?

It's tough to be precise based solely on your photos however it appears that you will need above average sized implants combined with a lift.  Whether a limited lift or a full lift can't be determined without examining you in person.

I think also that you need to be careful in choosing implants of that fairly extreme size for fear of complications over time from thinning and rippling/waviness as the weight of the implants stretches your skin and thins your breast tissue. 

Review best choices and options with an ABPS Bd Certified plastic surgeon before proceeding and good luck!

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

What would be best for my shape? Would I need a lift? Am I good candidate for larger implants?

Implants alone do not adequately lift the breast when there is significant sagging, no matter the size or the type, and will not produce a good cosmetic result in a patient who also needs some variation of a lift.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue,assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person and be very realistic about your potential cosmetic result.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Dimensional Planning and Pre-op op breast anatomy/appearance important in #breastaugmentation results!

You can elect to try implants alone, and then can stage the lift 4-6 months afterwards if so desired. Computer simulations are underwhelming in patients with challenging anatomy or who needs lifts. Best to seek a breast expert doing at least 300 augmentations annually. Best of luck.

Evan Feldman, MD, FACS
Texas Plastic Surgeon
5.0 out of 5 stars 88 reviews

Breast Augmentation

I think you would benefit from a breast augmentation.A side view would be helpful to determine the need for a lift (mastopexy). There are a number of potential size choices and shapes available.Computer imageing would be seful to help you determine the size and shape you feel is best.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

What to do?

 In my opinion, from the photos you have included, you would best be served by a moderately sized implant below the muscle in the dual plane with a vertical mastopexy. The size of the breast implants in my opinion, are predicated upon the natural base with the breast. Given the size breast that you have, even if a 800 mL implant can be placed, there'd certainly be no room at that point to do a lift and you would still have a nipple that pointed slightly downward. I would advise you to seek the counsel of a board-certified plastic surgeon with experience in breast lift with implants. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 reviews

Lift and implants

Yes provided you are a non-smoker in good health you should opt for a breast lift with implants. An 800 cc implant is rather large so you'll need consultation with a BCPS to decide upon the safest size for you. Good luck. 

Dr. B

Carlos Burnett, MD, FACS
Westfield Plastic Surgeon
4.9 out of 5 stars 38 reviews

What would be best for my shape? Would I need a lift? Am I good candidate for larger implants?

Yes you will need a breast lift in addition to implants.

Breast implant size should be based on the base width of your breasts which will be measured by your plastic surgeon.

Avoid large implants over 350-400cc. Implants in the over 600cc range will increase your chance of complications and likely will kill the nipple areola after the lift resulting in horrible scars. For more information please read below:

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.