Thanks so much for
sharing your question and all of your photos. The side angle is very
helpful and shows that your nipple is pointing out. You really are on the
cusp of needing a lift, but I think you may still be pleased with just
the implants. It is in your best interest to consult with a
board-certified plastic surgeon, preferably one who is a member of the
American Society of Plastic Surgeons (ASPS), who will complete a thorough
evaluation and decide what procedures you are a good candidate for. I
wish you all the best.
Implants do not lift the breast to any great extent. It looks like from the photos that you need a lift as well. Best of luck.
Hello again! The interesting thing about your question is that you show two results, both of patients with similar starting points to yours, one with a goal result and one with an unacceptable result in your mind. This highlights the importance of tissue characteristics that we, as plastic surgeons, are constantly referring to very strongly and what makes breast augmentation an art. You can therefore appreciate the need for an in person examination to render a real opinion. From the photos alone, I would place you at a Grade I ptosis and tend to believe that you do not need a lift if you are using hp 450-550cc implants. Good luck!
Transaxillary endoscopic approach using smooth round implants
The most sophisticated approach to
breast augmentation is through the armpit with a surgical camera (transaxillary
endoscopic). Using this modern approach the space can be crafted under
direct vision, with virtually no bleeding and no postoperative bruising.
Most importantly, the shape of the breast is meticulously created.
The other, older methods of insertion are technologically less advanced.
Both silicone and saline implants can be placed through the armpit by a
surgeon with skill and experience using this approach. The incision in
the crease is the oldest method of placing the implants and puts a scar
directly on the breast.
The best way to determine the size for
your personal perception of the perfect breast is to try on sizers. This way
you can see how they fit on you, how they add to your current volume, and
whether they fit your frame. Although the surgeon can guide you, only you will
be able to tell what is the right size. Try on sizers.
HP implants would be your best choice. Look at the charts with your plastic surgeon and pick an implant with the
base diameter and projection that you are looking for.
You have grade 2 ptosis, you will need a lift to have a good shaped breast with an implant. The implants will bottom out eventually if you go larger enough no to have a lift, this will really complicate any revision. We offer free consults if you would like a second opinion.
Breast lift or just an augmentation
I am leaning towards that you need a breast lift. Implants do not lift the nipple. In my experience, patients in your situation are not happy with just an augmentation.
Also, keep in mind that your nipple is not cut out. The incision is made around the areola and another incision is made around that one. The skin in between the incisions is removed.
I feel the only way to get the result you show as your goal is with a lift. You might be able to get away with a periareolar lift but I would defer judgement until your exam. You even want to consider shaped form stable implants to give you more of a lift.
#BreastLift or #BreastAugmentation
From the photos you posted, I think you already answered your own question. You show images of a post-op that you dont want, but you look very similar to the before image. Although you cannot translate this information from patient to patient, I think you can see why your surgeon suggested a lift.
If you choose not to lift your breasts, be prepared to do the surgery over again.
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon
How to decide if a lift is Needed
A simple rule of thumb: Breast implants do not lift breast, they only camouflage a sagging breast. If you look at the photographs you submitted, you will see that the nipple-areolar complex is not raised in any of the patients that had breast implants.
In your case, you have a nipple-areolar complex that is below the inframammary fold. By definition, you have grade 2 ptosis. An implant alone will give you the photo that you said you did not want.
A Tear Drop Augmentation Mastopexy leaves a small scar and a great shape. The implants are only of the size that gives you your desired volume.
For more information, read my book "Cosmetic Breast Surgery - A Complete Guide From A to Double D".
From your pictures, you have just enough droop that I think you would get the best result with some sort of lift, otherwise you might have some breast tissue hanging off the end of the implant. However, if you really don't want the scars, just have the implants only and see how you like them for a few months. What may be cosmetically unacceptable for me as a plastic surgeon (who is always trying to achieve the ideal) may be perfectly fine for you and your standard of what is acceptable.