Is SRF 385cc(L)/405cc(R) HP the right choice for scoliosis/asymmetric breast size and nipple height? Improve height?

Question

Scoliosis has altered my rib cage and I just want more symmetric full breasts. I'm most worried about the ending result on my nipple asymmetry (16cm and 17cm from center). Will the larger size (R) extend my lower pole enough to help level my nipples out? Do I need different profile implants? After my first consultation and waiting for my second, I'm looking for more opinions. Will I inevitably need a corrective surgery to bring up my right nipple after augmentation? Thank you!

Daniel Barrett, MD · Answer

Dear mandalala,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

Phillip Dauwe, MD · Answer

It sounds like your surgeon is making a good decision. Using implants that are too far off in size and profile, can create a worse asymmetry because the implant has different dimensions that will possibly be noticeable given your thin soft tissues. Time is your best friend in achieving symmetry. After surgery, the implants will put pressure on your rib cage and over about 6 months, your rib cage will remodel (change shape) fixing your asymmetry. If the implants are too different, you risk creating an asymmetry in the long run.

Tom J. Pousti, MD · Answer

Thank you for the question. Generally speaking,  patients with scoliosis are able to undergo breast augmentation surgery without difficulty. Any existing breast or chest wall asymmetry can be improved upon with careful pocket dissection and careful selection of appropriate breast implant type/size/profile. Make sure that your selected plastic surgeon has significant experience helping patients achieve the types of outcomes you would be pleased with.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.

David Finkle, MD · Answer

The bony structure of the chest definitely plays a role in breast enhancement procedures.  Sometimes we will even perform procedures to change/alter the ribs or sternum of the chest wall to enhance the overall appearance.  Based on the photographs submitted here is what I see:
Pectus Excavatum (sunken in breast bone) in the lower 1/2The right shoulder is higher than the leftThe left breast is larger than the rightThe left nipple sits about 1 cm lower than the rightHigh inframammary creases, bilaterallySmall, A cup, breast sizeSmall areolasWide cleavage areaA thorough physical examination with photographs and measurements would be needed for the most accurate evaluation.  Also, your expectations and the surgeon's skill and experience will need to be considered when formulating a surgical plan.
 Should we address the Pectus deformity? and how?  Do you want the left nipple elevated or left alone?  What size implants and subsequent postoperative breast size is best for you?
You certainly would benefit from breast implant surgery; I would place the implants under the muscle and recommend silicone implants, the remainder of the questions would need to be answered during a consultation.  I agree with 2nd and even 3rd opinions before undergoing any surgical procedure.
Good Luck!

Victor M. Perez, MD, FACS · Answer

The only way a plastic surgeon can give you an accurate opinion if after an in person consultation/examination.By looking at your pictures, you have asymmetry not only on your breasts but also on you chest contour (ribs and sternum) and this is important because implants will not correct those differences.In patients with small differences in size, like yourself,  I prefer to use the same size implant, if you use different size implant, after 2-3 years, usually you can see the difference in size, your tissues usually change with time, the implants do not.In most patients like you, a moderate profile implant is better, but again only after an in person consultation a decision for what type of implant is better, can be done.Be sure you elect a plastic surgeon member of the American Society for Aesthetic Plastic Surgery

Is SRF 385cc(L)/405cc(R) HP the right choice for scoliosis/asymmetric breast size and nipple height? Improve height?

Answers (5)

Answer: Pectus Excavatum and breast implants

Answer: Pectus Excavatum and breast implants

Answer: Choose the right surgeon

Answer: Choose the right surgeon

Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.

Is SRF 385cc(L)/405cc(R) HP the right choice for scoliosis/asymmetric breast size and nipple height? Improve height?

Answers (5)

Answer: Pectus Excavatum and breast implants

Answer: Pectus Excavatum and breast implants

Answer: Choose the right surgeon

Answer: Choose the right surgeon

Browse related questions

Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.