Do you agree with my plastic surgeons' comments and recommendations based on my desired outcome and before images? (Photos)

I am 39 years old, 125lbs, 5'9". I want my BA to look natural and I do NOT want to look top heavy. My PS recommended Sientra Classic 350cc. He stated that I am on the border of needing a BL but thinks that going with the 350cc size, that the outcome will look fantastic without a BL. I have attached a wish pic of a B&A of what I think is an ideal outcome. I think the front view of the V-Images look odd and my PS said they will look better than the image; however, I love the side and top view.

Doctor Answers 10


I agree with your surgeon that the Sientra Classic shaped implant can be an excellent option for the patient who is in the borderline category of needing lift. I have used this style implant many times in this situation with excellent results.

I would be very cautious about using wish pics and computer imaging as definitive guides for choosing a specific implant. The wish pic you have provided does not appear to have as much ptosis or sagging as your photo suggests, so concluding that the implant that looked good on that person will make it a good choice for you would be a mistake. The implant choices and results are absolutely not directly transferable to your situation. The greatest value of wish pics is in helping your surgeon understand your goals. The computer imaging tools are useful in helping you to get an idea what you will look like post augmentation, but they are not always good at  guiding specific implant size choices.

Based on my experience, and the images that you have provided, I would be concerned that the 350cc implant is not large enough to fill out your lax skin envelope, and I would suggest that you give serious consideration to going up to at least next size larger implant of 400cc. You are taller with a wide enough torso to comfortably accommodate that implant. In addition, the shaped implants tend to look smaller than a round implant of the same volume, particularly when placed under the muscle. I do not think that the next size larger implant would make you look "top heavy" and you could assess this with either imaging or a "try on" session which helps give you a sense of how the implant looks and feels on you.

Kirkland Plastic Surgeon
4.8 out of 5 stars 52 reviews

Sientra anatomical implants

I agree with your plastic surgeons choice. The classic implant can give a very nice slope at the top of the breast as it transitions from the chest wall.

Based on the photographs you submit, I would also be surprised if you will need a breast lift. I suspect the implant alone will give you a very nice result.

Good luck!

David R. Broadway, MD
Denver Plastic Surgeon
5.0 out of 5 stars 40 reviews

Good Selection

Based upon your photos and expressed goals, it appears you are mama king an excellent choice of implant, which will likely produce a very natural appearing result without breast lift.

It is true that the 3-dimensional imaging is an approximation with real post-op results typically looking better.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.6 out of 5 stars 39 reviews

Shaped implants are a good choice

Given your height, the moderate size of your chosen implants and the highly projecting lower portion of the implant, I believe this model will accomplish your goals.  I don't believe that one or two of the Vectra images are representative of what your surgical result will achieve.  I wish you the best.

D`Arcy Honeycutt, MD
Bismarck Plastic Surgeon
4.7 out of 5 stars 22 reviews

Do you agree with my plastic surgeons' comments and recommendations based on my desired outcome and before images

I agree with your surgeon that with the chosen implant you will look like the after on the imaging photos you have

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 27 reviews

Best breast implants for me?

Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.   

Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.

Given your concerns, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.

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 "top heavy" 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 (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with. 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Picking implants

It sounds like you have made a wise choice with regard to implant size and type (the Sientra Classic Based Anatomics are one of my favorites). Patients with borderline ptosis are more challenging because it is not always clear if a lift will be needed until you have the implants in. I discuss this with a patient pre-operatively and like having permission to do a lift if I am not happy with the look during surgery.

Best of luck!

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 24 reviews

Sure! You'll look great!

simulation software is not 100% accurate, but it does give you an idea. That is not exactly what you will look like, but that is a reasonably sized implant for someone with your frame. Go for it and good luck! 

Robert S. Houser, DO
Columbus Plastic Surgeon
5.0 out of 5 stars 15 reviews

Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 350cc seems reasonable. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Steven J. Rottman, MD, FACS
Baltimore Plastic Surgeon
4.9 out of 5 stars 78 reviews

Brest augmentation recommendations

Agree think this will be a nice option for you. I use the Vectra imaging as well and while it is a great tool to help you better visualize your results it can never replace an in person consultation and measurements with your plastic surgeon. Good Luck!

Jennifer Geoghegan, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 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.