Going from an A cup to 495cc silicone implants. Does Vesctra scan show exactly how they will sit? (photo)

Dear Calm305,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello, although I find 3D imaging to be a useful tool to explain the results of different implant profiles and sizes, it is not an exact science and it will not give an perfect prediction of the outcome.  Implant sizing should be based on a proper physical examination, understanding each person's desired result, trying on sizers, and looking at before & after photos.  Your surgeon will be able to provide advice about implant sizing after taking into consideration all of these factors.

Hello and thank you for your question. You are a great candidate for a breast augmentation.  The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.  Vectra has limited capabilities in breast augmentation in my opinion.  Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system.  

Best wishes and good luck.


Richard G. Reish, M.D. FACS

Harvard-trained plastic surgeon
 

Thank you for sharing your question and photograph.  Based on your before image as well as size of implants I would not anticipate your need for a lift and think your breasts should have a different appearance than that shown. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend seeing additional ASPS board certified plastic surgeons to ensure that the implants you decide upon are the right ones to meet your expectations.  It may also be wise for you to "try on" several of the implants so that you can have a better visual representation as to what they would look like.  Best wishes!

Thank you of your question and pictures.
No scan will ever be able to show exactly what things will look like post-operatively, but is a good way of showing a representation.
Looking at your pre-scan picture you do not need a lift, but I would advise a round implant so as to give you global volume enhancement rather than an anatomical (teardrop) implant as you will then have too much volume lower down and not enough higher up.
My advice to you would actually be to have a hybrid or composite augmentation where a smaller implant is inserted and the rest of the volume and shaping done with fat grafting.
I wish you well.
Marcus

Vectra is a wonderful tool to help patients understand their postoperative result.  However, it is not exact.  I personally feel that the image is never as good as my surgical result.  In addition, it cannot account for tissue stretch and muscle tone across all body types.  For this reason, it is helpful but not perfect.
One additional issue that your question raises is the idea of potentially needing a lift.  Breast augmentation will typically result in the implant sitting beneath the breast tissue in the "footprint" of the breast.  A breast lift or mastopexy will not and cannot change this "footprint."  Thus this procedure does not really lift and maintain the implant in an elevated position.  Your fullness after surgery will be more dependent upon the implant that you and your surgeon utilize.  Discuss your thoughts about a breast lift and breast shape with your surgeon so that he/she can do everything possible to meet your expectations. 

You do not need a lift.  The result will depend on implant profile and size. I do not believe that Vectra can fully demonstrate this.  You may need to consider high profile implants to restore upper pole volume.

After looking at your photos you do not need a lift.You could doa composite aug ie a silicone implant and then maybe some fat gr5afting to give more fullness to your upper pole.

Thank you for the question.
There are several steps taken to select a specific size/profile breast implant for a specific patient.  Generally speaking, although useful as rough guidelines and as communication tools, all the modalities currently used to predict what breast implant size/profile will best achieve a patient's goals with breast augmentation are NOT very accurate, in my opinion. The use of the rice test, sizers placed beneath a patient's bra, goal pictures, computer imaging technology (including Vectra)… are all useful, but not necessarily as accurate as one would hope.


In my opinion, nothing will replace careful verbal and visual aid assisted preoperative communication with your plastic surgeon, preferably in front of a full-length mirror along with the use of as many "communication" tools” listed above.


In my practice, I use all of the above modalities and then use intraoperative temporary sizers to help determine the best breast implant size/profile to achieve a patient's specific goals as closely as possible. For this reason, I think it is helpful to have the entire range of breast implant sizes/profiles available in the operating room.


Achieving realistic expectations prior to proceeding to the operating room is also an important part of the preoperative communication process. Patients should be aware that the results of their breast augmentation will not necessarily match exactly what they are visualizing with anyone of the above-mentioned communication tools.
 
Given your questions and concerns, I would suggest that you schedule additional time to spend with your plastic surgeon. This additional time spent will be helpful in the communication process and in alleviating some of your anxiety.


Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant 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. For example, I have found that the use of words such as “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 him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.


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 helps. Best wishes for an outcome that you will be very pleased with.

Hello. Thank you for your inquiry. It is important to have an in-person assessment regarding your concerns as it is difficult to determine virtually.

Exact end results and cup sizes are usually quite difficult to calculate as everyone has a different starting point.

There are many different factors that go into choosing a breast implant size which will correspond with your body dimensions while concurrently achieving your aesthetic results. Some of these factors are: Implant size (CC's), Implant profile (Low, Moderate, High), Placement of the implant (Subglandular vs. Dual Plane) etc. We utilize smooth round cohesive silicone gel 'gummy bear' implants for the best results.

During a consultation your aesthetic goals are heard and taken into account with the measurements of your breasts and the integrity of your tissue, as well as level of ptosis (sag). From here we collectively can find your 'perfect fit'. You are able to try out sizers and different implants in our office such that you can get an idea of what size you would be post-operation. We also offer Crisalix 3D plastic surgery virtual simulator during our in-person and virtual consultations to preview potential results. After your consultation, you will receive your very own implant sizers to take home with you (at a small cost) whether or not you decide to go forward with your procedure.

I usually recommend that my patients stop smoking, take vitamin C daily, and avoid aspirin/ibuprofen and vitamin E 3 weeks prior to surgery. I specialize in the 24-hour Recovery method which minimizes trauma to the breast and decreases pain post-operatively.

We encourage you to look at our website and Instagram (drkaraplasticsurgery) for lots of before and after pictures!
Please note that this response does not substitute patient-doctor relationship. We welcome any and all patients seeking advice to come in for a complimentary consultation available for limited time only.

During the COVID-19, we are offering complimentary online consultations as well as in-office consultation with social distancing and masks. Procedure done in-hospital private surgical facility while taking covid-19 precautions. We utilize UV-light to clean the air of viruses and bacteria during our consultations and surgery.

We invite you to come in to discuss your options more thoroughly. Please send us an email at info@drkaraplasticsurgery.com with the subject line: "Attention Meagan" and we will be happy to coordinate your appointment!

M.Kara,MD,FRCSC (27+ years experience) - Specializing in 24 hour recovery/ out to dinner breast augmentation in-hospital private surgical facility for your added safety and peace of mind