700cc & want 600cc implant, most importantly I would like a sloped shape - is this possible? (Photo)

Dear Noseyparker12,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Thanks for your question. A more natural appearance is achievable by downsizing the implants. You will also require adjustment of the skin envelope. The extent to which this is required will determine the scar pattern that will give you the best results. It may be achievable to adjust the skin using a periareolar approach (a scar around the nipple), and change the implant through separate inframammary fold incision if you wished to minimise scarring on the breast. A face to face consultation would be required to make a full assessment and provide more accurate advise tailored to your goals.

At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Hi, this is an interesting question. If you go down in size the breasts will seem emptier. Although the nipples point down the breasts are not truly ptotic and nipples are a t a reasonable level. I wonder whether you could go to a 600cc teardrop implant - this wouldn't be a whole lot smaller and a more natural shape and might find that it gives more projection behind nipples so they point up. So you could potentially get the improvement you want without an uplift maybe - and can always uplift subsequently depending on how they sellte after implant exchange.
best wishes Oliver Harley Plastic Surgeon

These implants are too large for your tissue and frame, and you would do better long term to go smaller. If you can, go down to 500-550 cc's in size. An examination is needed to see if a lift can be done. If these large implants have stretched your own tissue thinly, then a lift would be very risky to your areolae-nipples. Your pockets can be tightened internally so that the implants do not move too fat to the sides, especially when you lay down.