Droopy, small, large areola boobs, 19 years old, can I achieve my wish pics? What are the risks? (photos)

Good morning!I think you can achieve that size and look with a donut mastopexy, under the muscle augmentation, High Profile silicone gel implants in the 400-500cc range.

Hi Brianna, thank you for your question. I think you are a very good candidate for a breast augmentation with a "circumareolar" breast lift.  The implants would give you the volume and cleavage improvement that you are looking for. The breast lift would address the "droopiness". A "circumareolar" approach to a breast lift (in which the lift is done using an incision around your areola only) would address your areola size.

Hi Brianna__,

Determining whether you need simply a breast implant versus a breast lift or both can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position.

Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just breast augmentation depending on the size of the implant the patient wants. I often use an implant when I perform a breast lift because it provides more upper breast fullness after the lift.

These two surgeries can be done at the same time and this may be optimal as the risks can be minimized. 

My preferred lift is a lollipop lift when a periareolar won't do (ie greater than 2cm lift required). The lollipop technique was created by a Canadian plastic surgeon named Elizabeth Hall-Findley and treats the breast as a three dimensional structure instead of two dimensions (anchor - lift).

Most importantly, it does not require the horizontal component scars that the anchor-lift requires and breasts appear much more natural, lifted, and less boxy. Lastly, the lift lasts longer because the lollipop doesn't rely on the skin to hold the breast up, it is actually breast tissue that is being brought together to support the breast and hence improves longevity.

In addition, upper pole fullness is achieved with appropriate implant selection but more importantly, submuscular placement, and precise pocket dissection. The submuscular placement allows the muscle to cover the top part of the implant which allows the upper pole to appear fuller. Keeping away from the lateral chest during pocket dissection allows the implant to remain higher and prevents it from falling off to the side.

You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD, MHA, MS

Certified, American Board of Plastic Surgery

Member, American Society of Plastic Surgery

Member, American Society of Aesthetic Plastic Surgery

Hi there. I think you can probably get close to your wish pics, with the understanding that making your areolas that small is going to be at odds with making the volume of the breast that large. You might consider somewhere in the middle where you have an increase in volume and/or not have areolas as small as the photos you provided. It is really part of the conversation you would have with your board-certified plastic surgeon during a formal consult. Hope that helps!CDK

Dear Brianna,
Thank you for posting your question and photographs. Going by what you have said and your photographs, a breast augmentation with a cicumareoalar lift  (and areaolar reduction) may be the best procedure for you. I would not advise going for too large an implant as that puts more of a long term stretch on your tissues but a moderate sized implant in a style that suits your breast tissues may give you a very nice look. 
In terms of undergoing surgery age 19, if your health is good then then the risks are low. However, two things to consider at 19 are; Firstly if you have breast implants placed at 19, you will need further surgery at some point in the future. The implants willl need to be changed and with age, pregnancy and weight changes, your breasts may change over the implants too. Secondly some types of breast lift can affect breast feeding so please consider this as well and discuss wiht your plastic surgeon if you dicide to have a breast lift. 
I would suggest that you see a board certified plastic surgeon for a full assessment. They can go over implant sizing and styles, breast lifts and arealar reductions with you as well.
I hope this is helpful.
Best wishes

The best advice would come from an in-person consultation from a plastic surgeon. Typically, breast measurements are taken and most surgeons will recommend a range in volume (cc's) that would look natural for you if that is the "look" you are going for. In my practice, I let patients try on sample implants to see what kind of implants looks best with their shape and size. I rarely go by cup size. Regarding your areola, they can be reduced in size during this procedure. 

Thank you for your question. I recommend consulting with a board-certified plastic surgeon in your area who is also a member of the American Society of aesthetic plastic surgeons. Your goals are very achievable. I recommend an augmentation with possible circumareolar lift. The augmentation will give you fullness and the circumareolar lift will decrease the areolar size. Best of luck with your procedure. 

In my opinion, the treatment of your condition to reach your goals would include a reduction of both areolas, which would involve a circular incision along the outer border of each areola.  The right nipple appears to be lower than the left and this could be corrected through the same incision.  To achieve the breast volume you desire will require a rather large implant.  It does not matter whether you choose silicone or saline implants, although silicone implants or the Ideal saline implant has a more natural feel.  Placement of an implant itself does raise the height of the nipple and there would be relative lowering of the fold beneath the breast to accommodate the size of the implants.  With any type of surgery there is a risk of bleeding, infection and pain.  Particulars for a breast augmentation include some residual size or shape discrepancy between the right and left breast, capsular contracture, implant rupture, numbness of the nipple and to the possibility of needing future implant replacement due to the fact that implants do not have an unlimited life expectancy.  I hope this response answered your questions sufficiently.

Your wish is very achievable.  I would suggest you have a consultation with a board certified plastic surgeon in your area who specializes in breast augmentation/lift.  I encourage you to look through their portfolio of before and after pictures to ensure their work is what you are looking for.  I would suggest an augmentation with a lift in which the size of your areola can be made smaller.  
Best wishes!

Dear Brianna,Hello and thank you for your excellent question. Breast implant sizing is a combination of current versus desired breast size, chest wall and breast measurements, and skin and subcutaneous tissue quality. I think that your goals are reasonable, but you may need additional surgery (like a lift) to reach them. You should be evaluated for a No-Vertical-Scar breast lift technique. There are a number of no-vertical scar breast lift techniques, but my preferred technique is the Bellesoma Breast Lift technique. Our technique provides an exceptional breast lift, upper pole fullness, relief from neck and back pain, and no vertical breast lift scar. It uses a woman’s OWN breast tissue to produce an internal suspension technique, without the need for a breast implant. It does not disturb the nipple, areola, or breast glands, so sensation and the ability to lactate is preserved. It uses 3D scanning of your breasts and body to design a procedure specifically designed for YOU, and you alone. Finally, for patients who desire breast enlargement, it can be combined with fat grafting. It is best to answer your question during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!

Best,

Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

Texas “Top Doc” 2017, 2018

RealSelf100

America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 – 2018

BeautyAdvisor Top Contributor