Round or teardrop implants for tuberous breasts? I want the largest and fullest look possible. (photos)

Question

Hello, I am due to have a breast augmentation with high profile 350-400cc depending on what will fit and a nipple lift in a few weeks but cannot decide between round or teardrop implants. I have tuberous breasts. I really want the round implant for a fuller upper pole look but my surgeon has reccomended teardrop as unsure even with a nipple lift my nipples will be centeral and may be on a slight downward slant with the round, he has left it to me to decide which I want to go for. Any advice?

Daniel Barrett, MD · Answer

Hi tinkerbell321,
  
Tuberous breasts are not simply small or underdeveloped breasts. The appearance of the breast can range from mild to severe, and typical traits include: enlarged, puffy areola, rather wide spacing between the breasts, very little breast tissue, sagging, higher than normal inferior breast fold, and narrow base at the chest wall. 
  
The type of surgery best for you will depend on the severity of your condition. 
  
My preferred technique for tuberous breast correction involves a multistep procedure where the breast tissue is released in a radial pattern to prevent herniation into the areola and placement of a custom implant size is in the breast to allow appropriate expansion of the breast in the restricted dimensions. This can often be done in a single procedure but sometimes may require two surgeries.
  
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.
That said, it is best that you visit a board-certified plastic surgeon for an in person examination. Only after a thorough examination you will get more information and recommendations.
  
Daniel Barrett, MD, MHA, MS
  
Certified, American Board of Plastic Surgery
  
Member, American Society of Plastic Surgery
  
Member, American Society of Aesthetic Plastic Surgery

Luis A. Mejia, MD · Answer

hello thank you for your question and provided information as well.. based in your pictures and in the case , you are a good candidate for breast augmentation in position sub muscular , in you case its recommended get a consultation with a plastic surgeon to check how many cc do you need to get very well results.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation with release of lower pole constriction bands.  I recommend a smooth round implant rather than a teardrop implant which has the risk of malrotation over time.  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

Kenneth Hughes, MD · Answer

Round implants have the advantage of not rotating out of place.   It is true that the anatomic implants always have the potential for rotating and creating a contour issue.  Fullness of the breast is concentrated more in the bottom portion of the breast with teardrop implants and at the top with round. For women who do not have a lot of existing breast tissue, the teardrop may be the better option.  Your PS has the advantage of examining you in person, and based upon his/her experience and training, you might opt for his recommendation of the teardrop for your tuberous breasts.Kenneth Hughes, MD, Board Certified Plastic SurgeonLos Angeles, CA

Milind K. Ambe, MD · Answer

Thank you for your question and photos.  I would select round implants, not tear drop.  It sounds like you wish to have more upper pole fullness and tear drop will not get you that look.  Personally I would select round.  Best of luck to you.

Jorge Jiménez Toribio, MD · Answer

Hi dear, thank you for your question and the provided pictures.Usually I recommend teardrop type of implants to give the fullness and natural kind of look as result. My patients with your same situation have been satisfied with the final outcome and feel comfortable with this implant too. Rounded usually stay in place and give a full kind of look too but tend to provide it more at the top as you said.Hope this helps and good luck!Dr. Jiménez ToribioPlastic and Reconstructive Surgeon

Tom J. Pousti, MD · Answer

Thank you for the question. These  days there are a variety of breast implants available;  the variety of breast implant available raise a lot of questions from women considering breast augmentation surgery. Personally, I think that for most patients considering breast augmentation surgery, careful selection of plastic surgeon  and careful communication of goals, far outweigh the specific type of breast implant utilized (when it comes to the success of the breast augmentation procedure).
Anatomical breast implants were designed to better simulate the natural breast  shape;  the problem with these implants is that if they shift or rotate,  the entire breast will change shape as well.  This change in breast shape may require further surgery to correct. Round implants, on the other the hand, can shift or rotate without changing the shape of the breasts.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 “very natural” or "C or D cup" or "fullest look" 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.

Round or teardrop implants for tuberous breasts? I want the largest and fullest look possible. (photos)

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