The smaller the implant, the shorter the recovery time? Wondering if smaller = less risk/pain, & longer lasting results? (Photo)

Question

I'm considering BA and/or breast lift. I'm 5'8, 133 lbs, mid-30's, exercise reg, & recently started weights. I feel like my breasts droop b/c my weight has gone up/down throughout my life, esp. as a teen. My areolas seem too big for breast size. I'm 34-36A, would like B or even C. I'm worried a lift won't be enough & I need implants too (under muscle?) resulting in more pain/longer recovery & difficultly having mammograms later. Would 250 cc's BA (no lift?) be enough for a B cup & minimal risks?

Thomas A. Mustoe, MD, FACS · Answer

In my experience implants of less than 300 cc placed under the muscle cause very modest pain, with normal activity except exercise within 2-3 days.  Large implants (450 cc and up) cause more stretch, and so the initial recovery is longer and somewhat more intense.  Very large implants increase the risk of implants falling over time, they are easier to palpate, and long term cause more problems. You are anticipating a modest size implant...and I would choose the best size: between 250 cc and 350 cc you should not have any increased problems.  It does not appear from your pictures that you need a lift, but that is best determined with an in person consultation.

Sheila S. Nazarian, MD · Answer

Honestly, I would advise you to seek out the right size implants for your body and your goals instead of focusing on which ones may hurt less. I think you'll be happier in the long run. Best, Dr. Nazarian

Donald R. Revis Jr, MD · Answer

Good afternoon!Although you did not provide a topless photo, you describe your areolas being large and out of proportion to your breasts, and in the tank top your breasts do look a little "deflated" look, so I would 
recommend a lift with submuscular silicone gel implants, to 
give you a nice soft natural but perky look. A lift by itself is just 
not going to do the trick.In
 my office I would take your chest measurements, review photos with 
you, and then have you try on the implant sizers to make sure you select
 the correct size and profile to achieve your goals, but 250cc may well be enough  to
 accomplish your goals.And you re definitely correct- the smaller the implants, the faster and easier the recovery!I have attached a link to my Breast Lift / Breast Augmentation photo gallery for your review- hope it helps!

William Andrade, MD · Answer

Hello, in my experience people who choose large implants in proportion to their body size do tend to have more initial pain and discomfort, and oversized implants are more likely to be associated with rippling and other problems.  Of course, complications can happen with any operation or implant size, but disproportionately large implants have additional risks.

Tom J. Pousti, MD · Answer

Thank you for the good questions.  Overall, I would suggest that you try to get your breasts "just right"; not too big, and not too small.  Also, generally speaking, your thinking is correct; the use of smaller breast implants can be potentially less problematic compared to trying to "push the envelope" when it comes to breast implant selection.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant type/size/profile selection) 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. In bra sizers can be useful communication tools also. I have found that the use of words such as “natural” or "B 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. The use of computer imaging may be very helpful during the communication process.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery ( after the use of temporary intraoperative sizers). 
I hope this, and the attached link (dedicated to breast augmentation surgery concerns), helps. Best wishes for an outcome that you will be very pleased with.

Scott L. Replogle, MD (retired) · Answer

The short answer to your question is no. The pain/risk/recovery and comes mostly from the creation of the pocket at the base of the breast and any adjustments to the breast and pec muscle, not from the implant put in or its size. The usual size increase for breasts with normal width for the chest circumference, is 1-2 cup sizes depending on the profile (from lowest to highest) and for smooth surface, round implants placed behind the pec muscle for the upper half of the breast. Support and protection is used post-operatively for about two weeks to make sure the implant is properly healed in position. The problems and risks for breast augmentation procedures is usually due to implants that are too wide for the base of the breast which forces the tissues to stretch and adjust to the implant like putting a too big foot in a too small shoe. Other problems include excessive release of the pectoralis muscle on the medial border of the breast in order to narrow the cleavage gap which positions the implant where it isn't behind the base of the breast and causes potential risks and deformity.

The smaller the implant, the shorter the recovery time? Wondering if smaller = less risk/pain, & longer lasting results? (Photo)

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