Mastopexy/implant replacement with tuberous breast, what profile would be best? (Photo)

Hello, I am preparing for a mastopexy with implant replacement this week. I was wondering if a moderate +, or HP implant would be best suited for me, since prior to my first breast augmentation I had tuberous breasts. I currently have 410 cc implants, and would like to keep a larger/natural look. I included some pictures of what I would like my desired results to be. Any suggestions as to which profile and sizing would be best? Also submuscular/subglandular placement? Thanks in advance!

Doctor Answers 9

High or low

The question of high or low profile implants is a simple question to answer. First it should be the surgeon who makes this call, not a patient choice and your surgeon should educate their patients on this. your breast has a width across the base. That base width should closely match the impland width. It is sort of like shoe sizes. Lets say you wear a size seven shoe but you really like these size three shoes. That really does not matter because your not going to get your size 7 foot into a 3 shoe. if your breast base is 11 centimeters in diameter then you dont want a 15 centimeter implant. it is as simple as that, so the voume you want the implant to be will determine the profile of the implant and therfore the diameter. hope this helps.


Sacramento Plastic Surgeon
4.6 out of 5 stars 42 reviews

Sizing Questions

Hello,

No one can answer your question regarding sizing well or accurately without an in person examination. Rather than focus on photos, it is better to do in office sizers to see how you look in the mirror, a much better determinant of your happiness.

As for profile implant, in general lower profile (mod plus) has fewer complications through time than high profile implants. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Mastopexy/implant replacement?

First, let me just say that I believe that your original surgeon did a very nice job given your pre-operative shape. All of your 'wish' photos show a very full round shape most consistent with high-profile implants. Having said that, I would always recommend that you go with your local plastic surgeon's recommendation based upon his/her experience and examination. Finally, your areolar diameter remains somewhat large, but could be down-sized with a periareolar lift at the time of implant replacement. Best of luck with your upcoming surgery.

Michael F. Bohley, MD
Portland Plastic Surgeon
4.9 out of 5 stars 15 reviews

Implant profile

In my opinion, the moderate profile implants work best with your breast type including a mastopexy.  It is the cc volume that is the most important factor.

Mastopexy surgery

Thank you for your question and photos.  Since you are already scheduled for surgery this week I trust that you have full confidence in your chosen Plastic Surgeon.  I would hope you are showing your PS your desired results photos so that he/she can make the best selection for you based on your in person exam and measurements.  It appears that either a Moderate Plus or HP profile could work nicely for you so I would base that on your measurements.  If you have any concerns that your Plastic Surgeon isn't capable of making the right implant selection for you then I would suggest you see some more Board Certified Plastic Surgeons in your area.  Best of luck to you!

Milind K. Ambe, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 36 reviews

Mastopexy/implant replacement with tuberous breast, what profile would be best?

Thank you for the question and pictures. You will find that you will receive a variety of different opinions from the respondents on this website. Ultimately, careful selection of your plastic surgeon and careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical.

Given your concerns and that your surgery is coming up soon, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.

Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.
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 “larger, natural” or "C or D cup" etc 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.
3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.
I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.

Implant selection with breast lift

It is very important to avoid a high profile implant during a simultaneous mastopexy. This is because projection is increased by virtue of a lift and when an implant is also placed under the nipple areola, it can look distorted and tubular. Please consider a moderate or moderate plus profile implant instead.

Arian Mowlavi, MD
Orange County Plastic Surgeon
4.9 out of 5 stars 45 reviews

Revision

High profile replacement under the muscle would be preferable. Better upper pole fullness with less lateral width.

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 40 reviews

Want to be larger

 From your photographs, my opinion would be that you should go up at least 150 to maybe 200 mL and the wider base meaning the moderate plus would give you more of the look you want with this increase in size.  I would likewise keep the implant in the sub muscular plane if it's  already there.Without seeing how much room there is in your skin envelope, this is only a guess. I recommend that you see your plastic surgeon who can best decide what would work in your situation.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 46 reviews

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.