High profile or moderate plus? At what volume? (Photo)

Question

Stats: 5'4", 125lbs, 35, no kids. VS bra size: 32C or 34B (I do not fill out the cups in 34B) Measurements: 30" around ribs, 34" widest part of chest, diameter of breast 13cm. Look desired VERY natural full C or small D. I DO NOT want torpedoes on my chest. A PS suggested 400 to 450 HP silicone Mentor implants with a crescent bilateral lift. 1) would the HP look natural on my frame? Or moderate plus profile? 2) is 400 to 450 too much for size desired?

Luis M. Rios Jr., MD · Answer

Thanks for the stats. They help a lot.Let me review your expectations. You are a 34B and you want to be a natural C or small D. Your current diameter is 13cm.Here would be my recommendations based on the numbers:1) 400cc HP will probably be a D cup but would fit your diameter.2) A 350cc Moderate Plus might get you a natural C or small D and fit your diameter.3) I don't think you need a crescent lift. Your nipples are centered and pointing straight ahead.Now, plastic surgery is not a complete numbers game, so a thorough consultation would be needed. Remember, all bra manufacturers have different cup sizing and are very inconsistent. At best, plastic surgeons can only guess a cup size. They cannot guarantee a cup size because all stores measure differently.The goal of the consultation is for the plastic surgeon to understand the patient's expectations by listening to the patient and possibly seeing some images that the patient brings. After that, the plastic surgeon tries to demonstrate what certain implants might look on a patient's frame.There are several ways to do this.  The implants can be placed in a tight shirt and shear bra and the patient can see if the size matches well with their body. If a plastic surgeon has computer imaging, like Vectra 3D, he can show the patient what she might look like with certain sizes.Once the patient is comfortable with a size, the plastic surgeon measures the diameter of the breast to pick the best width (profile) in order to obtain optimal fullness and cleavage.If the surgery achieves the look the patient saw in the consult, then whatever bra size fits really doesn't matter. In other words, concentrate more on the look than a cup size. If you need more clarification, go back to your original surgeon or get a second opinion. Numbers are great, but sometimes you need to see it to believe it!Good Luck!

Gary M. Horndeski, MD · Answer

At
size 32 B, each 100 cc corresponds to 1 cup size change.  If you want to be a C, it would only take 100
cc to go from a B to a C.  Instead of
doing augmentation with implants, I recommend a breast lift with fat
transfer.  There is a new technique
called The Bellesoma Method, which will reshape your breast tissue creating
upper pole fullness without implants, elevate them higher on the chest wall and
more medial to increase your cleavage. 
Vertical scars are avoided, nipple sensation and the ability to breast
feed are maintained.  At the same time or
later, fat transfers can be performed if additional volume is desired.  400 cc to 450 cc implants are huge, not stable
and will descend.Best Wishes,Gary Horndeski, M.D.

Keith Hodge, MD · Answer

A high profile implant will give you more upper breast volume when compared to the moderate plus. To help you decide on volume, I would suggest trying on implants with a sports bra so you can visualize your post-op appearance. The crescent lift is optional since you will get a modest lift from the augmentation. Good luck!

Ted Eisenberg, DO, FACOS, FAACS · Answer

Both are good. There is a subtle difference. I recommend you look at pictures of women with similar measurements to you with both implants. My patients tell me that this process helps them determine which is best for them. More seem to choose Moderate Plus over HP.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

Jeffrey Thaxton, MD FACS · Answer

Based on your measurements, bra size and photos and your stated goals.  The implants recommended seem too large.  For your size frame a cup size increase is 150 to 200cc, since you are only wanting a cup size or cup size and a half a 200 to 300cc implant would be enough volume.  With the base width of your breast a moderate or moderate plus implant of this volume would have a better match to your breast width. 
You do not have significant ptosis (droopiness), I don't believe a crescent or any other type of lift is needed.  A dual plane augmentation technique can give you a slight lift without any additional scarring.  
Be sure to have a consultation with a surgeon certified by the American Board of Plastic Surgery, any physician certified by any medical board can call themselves "board certified" but will not have the training and experience of a board certified plastic surgeon.
Jeffrey Thaxton, MD FACS
Certified, American Board of Plastic Surgery
Member, ASPS and ASAPS

David Graham, MD · Answer

If you want a natural result in a C or small D cup then a moderate plus profile 350-400 cc implant would be the way to go.  You have a long chest so the increased base width of a moderate plus profile implant would be desirable as well. You already have some breast tissue so I agree that a 450 cc implant would be too much.

Tom J. Pousti, MD · Answer

Thank you for the question. Although I cannot provide you with definitive advice I can tell you that I think (my opinion) that a crescent breast lift does not provide  significant  enough of a breast lift  to be valuable; in other words, it generally accomplishes nothing of significance, and will expose you to risks of areola distortion/elongation/poor scarring.  
  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. Sometimes, it is necessary to seek several consultations before you feel comfortable about your choice.
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 "torpedoes" etc may mean 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, best not to discuss your goals and/or judge the outcome of the procedure performed based on achieving a specific cup size. The use of computer imaging may be very helpful during the communication process. The use of in bra sizers may also be helpful. In other words, use as many “visual aids” as possible during the communication process. I encourage patients to meet with me as my times as necessary, to feel comfortable that we are both on the “same page”.
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. I generally select appropriate breast implant size/profile after the use of temporary intraoperative sizers and viewing the patient's chest in the upright and supine positions.
 
I hope this helps. Best wishes for an outcome that you will be very pleased with.

David A. Sieber, MD, FACS · Answer

Thanks for the great question! If you want a natural result then I would not recommend a high profile implant. If your base width is 13, then you should still be able to fit a 400cc moderate plus implant. The general rule is that each 150-175cc takes you up a cup size. Your breasts naturally sit a little lower on your chest wall. Because of this, higher profile implants may tend to look more "augmented" than moderate plus implants. I recommend finding someone with 3D imaging in your area. This will be able to show you what you'll look like with different size and projection implants. Best,~Dr. Sieber

David Finkle, MD · Answer

There is no right or wrong answer and every plastic surgeon will have their own opinion based on their training, experience and education.Based on your photographs, desires and measurements.  I would recommend the moderate plus profile (not high profile) implants, silicone, under the muscle, no lift needed and the 400 - 450 cc range would be fine.Good Luck!

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