Breast augmentation 32C wanting 32D/DD. Want more fullness on upper pole. Female, mom of one. 5'7" 125 pounds (Photo)

Question

Had consult for BA and after trying on sizers, my Dr recommended 250 cc saline implants w/ dual plane placement. I don't want to be much bigger than what I am now but would like them to appear perkier & fuller on top. Would this size and placement work for me? Dr said I could do a lift bc I have mild ptosis. Do I need a lift? I've never thought my breasts were saggy. I'm scared of going too big but also scared of going too small and then not being able to tell a difference.

Dustin L. Reid, MD · Answer

I think that you could do fine with just a breast augmentation and this will fill out the top of the breast more.  However, if you truly don't want to be much bigger and want to be significantly "perkier", then you might consider a breast lift.  This is going to give you more of that type of result.  Good luck!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation using a dual plane technique without need for a formal lift.  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.  This entire surgery
can be performed with a small incision technique.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

Joe Gryskiewicz, MD, FACS · Answer

Hi OliveYou,Yes, the size and placement would work for you.  I believe a bit of an internal lift called the dual plane would be a good bet.  I would NOT do a breast lift, because we do more breast augmentations than anyone in the area, and I don't see the need.  A small implant would still do it all for you, in my opinion, but I would have to examine you to be sure.
We would also use the quick recovery approach for you!!
Please
put an index card in your breast fold. If your nipple is at the edge of the
card or below, then you would be a candidate for a lift, either a vertical or
anchor or areolar incision. If your nipple is above the edge, you could be a
candidate for an internal lift called the dual plane. The
video below explains the dual plane internal lift.  I also attached an article from a peer-reviewed
journal to give you an even better idea.  I believe the dual plane and implants alone
will do it for you, and that you will not need a lift. Be sure to seek a
consultation with a BC PS to be sure. All the best, “Dr. Joe”

Jonathan Amspacher, MD · Answer

Selecting breast implants can seem like a dizzying array of choices.   The good news is based on your overall appearance you'll likely get a good result with most reasonable size choices.   I think 250 cc is a fairly conservative augmentation volume.  This will give you an improvement in size but I don't know if it will give you as much upper pole volume as you desire on a 5' 7" frame.  I would recommend that you put on a tight sports bra and try on several implants to see if they get you to the size and projection that you desire.  If you want perfect nipple position you may consider a lift but if you are willing to have improvement, but maybe not all the way to ideal position then you appear in your photos to be fine without a lift.  Best of luck on your Journey

Daniel Barrett, MD · Answer

Dear oliveyou,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

David A. Robinson, MD · Answer

Based on the photos you shared, I believe you would be a good candidate for breast augmentation. I  do not feel you would need a lift to achieve your desired cup size or to establish fullness on the upper part of your breast.  A dual plane approach is very common when performing breast augmentation surgery. I am not sure why your surgeon recommended using saline implants, unless this is your preferred choice.
I mainly use silicone implants for my breast augmentation patients and find they work very well. They have the advantage of looking and feeling more natural than saline implants and tend to have less rippling as well. 
It is difficult to say what size implant you will need to achieve your desired cup size and upper breast fullness. Make sure your surgeon understands the look you are trying to achieve before going to surgery. If you are not sure about his/her recommendation, I would seek a second opinion.
Good luck.

Scott W. Vann, MD, FACS · Answer

Your nipples are well above your breast fold so you do not need a breast lift. I think dual plane placement is an excellent idea. A 250 implant is a very modest size for someone your height. I would try on sizers again to make sure you are happy with the final look. Good luck.

Jeffrey H. Lee, MD · Answer

Hi and thank you for your question!  First off, it does not appear you need a lift so I would go with implants alone.  What size implant is a hard choice to make but I would probably recommend going with something a little larger than 250cc.  At 5' 7" your frame will be able to accept a wider variety of implant sizes without it looking too big.  I would be a little worried that you would not see the difference you desire with a 250...I would  start with a 300cc or so, especially because one of your concerns is having the surgery and not seeing a big enough change.  The other variable is what profile implant to use because a moderate vs high profile implant can look different even at the same volume.  Best of luck!

Daniel Bortnick, MD · Answer

Hi and thanks for your question and photographs. You have an extremely common exam after having a child. Remember that shape should be the goal for ALL cosmetic surgeries. After children, weight loss or the aging process itself, the breast always loses shape. Upper pole fullness decreases, forward projection decreases, breasts move under the arms, and the nipple/aerolar complex falls. If these shape changes are minimal, called glandular or pseudoptosis,  like yours, sometimes the best compromise is am implant in the dual plane position, (type 2 or 3) or even subfascial. I don't think that the scar from a lift would be the right compromise for you but it would give you slightly more fulness and allow a slightly smaller implant. So either way is fine you have to choose between the compromises. Good luck.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.  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.  Breast lifting does not appear to be necessary. Make sure that you learn about the pros/cons associated with the use of saline versus silicone gel breast implants, as you make your decisions.
 
  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 "fuller on top" 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.
 One question that might be helpful for you to consider: would you be more disappointed if you are slightly too big or slightly too small after the breast augmentation procedure?
I hope this helps. Best wishes for an outcome that you will be very pleased with.

Breast augmentation 32C wanting 32D/DD. Want more fullness on upper pole. Female, mom of one. 5'7" 125 pounds (Photo)

Answers (12)

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