What placement and size? (Photo)

I am 5ft 8 with a slim build but curvy bottom half. I am 10stone/140lbs so healthy weight size 8-10 in clothes. I have quite a bony chest and small breasts that have some sagging from breastfeeding and childbearing. I want implants to give volume and lift - fill out the loose skin. I don't think I need uplift? I am size 34b at present and I am thinking 34d or 34dd as I am tall and this would bring me into proportion. Does this size seem reasonable? Also do I do over or under muscle ? Thank you

Doctor Answers 12

Breast Augmentation with The Horndeski Method™

Your breasts are small and sagging.The added weight of implants will make them sag even more.I recommend a new technique called Breast Augmentation with The Horndeski Method™.Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant.Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision.Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it.At size 34 only 200 cc implants would be required to go from a B to a D.

Best Wishes,

Gary Horndeski, M.D.

Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

My recommendation

Subfascial is the less aggressive and most modern trend, with anatomical shaped implants, cohesive gel filled and macrotextured.

Alejandro Nogueira, MD
Spain Plastic Surgeon
4.9 out of 5 stars 45 reviews

What's Best for Me?

Your best advice will come from a board-certified plastic surgeon who can examine you and discuss your goals and concerns in more detail.  Based on your comments and photos, however, it does not appear that a breast lift will be required.  Since you are thin with minimal breast tissue I believe that silicone implants placed in a dual plane location will give you the best result.  With respect to size it is impossible to say but you should be certain that the base dimension of the implant is appropriate for your frame.

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 81 reviews

What placement and size?

My over the internet guess is 450 cc moderate profile + unders as the response for you..............

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews


You look like a good candidate for a breast augmentation but an exam in person is essential to properly size you. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Submuscular implants

I would suggest transaxillary endoscopic sub muscular implant (armpit incision with a camera under the muscle).  The size should be determined by you by trying on sizers.  The cup sizes you are describing would require something in the 460 to 550 cc range, at least.

Gary Lawton, MD, FACS
San Antonio Plastic Surgeon
4.9 out of 5 stars 136 reviews

Start with the consultation

I agree that you should not need a lift if you want a fuller look.  Most likely a high profile smooth round silicone implant placed under the muscle in a dual plane approach will give you the look you are talking about.  As long as the base width of the implant matches your frame you should have a good result.

Jason Brett Lichten, MD
Columbus Plastic Surgeon
5.0 out of 5 stars 18 reviews

Implant Choices

I doubt you will need a lift. As far as implants go, your surgeon should have multiple sizers he or she can use to give you a good idea of your ultimate shape with a given implant. Depending on the look you are going for you can choose between moderate, moderate plus, or high profile in round or shaped implants. They also offer different base widths. Most patients prefer under the muscle.  Allergan, Mentor, and Sientra all have large selections. You appear fit with good bone structure to start, so I expect you will have good results with any number of implants.

Sarah A. Mess, MD
Columbia Plastic Surgeon
4.7 out of 5 stars 21 reviews

What size and placement? Do I need a lift?

You do not need a breast lift. I would recommend submuscular placement with a dual plane approach ( allowing pectoralis muscle to slide up slightly), which allows a more natural tear drop shape, and a more natural appearing superior pole in a  patient like yourself  with minimal soft tissue over your upper chest.  In addition, there are other advantages, but in many European and South American  countries subglandular placement is popular.  Regarding size, that is best determined with use of goal pictures, and sizing implants, and possibly 3-D imaging. There is no definition of bra size, and some of the decision benefits from an in person consultation. With your frame, and the approximate size that you are looking for, implants within the range of 350cc to 500 cc would be appropriate, depending on your goal pictures.

Thomas A. Mustoe, MD, FACS
Chicago Plastic Surgeon
4.8 out of 5 stars 96 reviews

What placement and size?

Thank you for the question and pictures. I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.   Breast lifting is not necessary. In my opinion, it is in most patients' best interest to have their breast implants placed in the sub muscular (dual plane) position. You will learn a lot about the pros/cons associated with different breast implant positioning on this website. 

 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. I have found that the use of words such as  “natural” or "C or D cup" or " bring me into proportion” etc means different things to different people and therefore prove unhelpful.

 Also, as you know, cup size varies depending on him 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 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.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 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.