Full profile or demi for more upper pole fullness? (Photos)

Question

Hello! Keen to hear some thoughts around this if I may? Stats:- Mastopexy with implants in 2024 due to excessive weight loss. Thin, loose skin, drooping of breasts. Age 36 Seeking upper pole fullness, a handful in size. Motiva Demi round profile 300cc currently. Revision surgury pending. More skin is due to be taken from under each breast and the nipple repositioned to be more symmetrical with other. Feeling bottom heavy with no upper pole currently. Implant feels wide across chest wall. Breasts feel flat on chest. Goal:- More upper pole fullness, same sized breasts or smaller Currently looking at Motiva full round profile as I understand the width will be lesser and the projection forward and potentionally upwards will improve. Consideration around maining a similar weight of breast at 295cc. Any thoughts to offer around this? No comments around the breasts looking fine now please, that’s not what I’m asking. Thank you

Gary M. Horndeski, MD · Answer

The width of your breasts is slightly larger than the chest wall. I recommend slightly smaller implants in terms of the width of the base. You also need the pocket re-positioned higher if you want more upper pole fullness. The concept of removing the skin between the horizontal incision from the previous anchor incision to the inframammary fold is a good idea. This can be resected or deepithelized and used to maintain volume.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Yasemin Aydinli, MD · Answer

Since you already have a revision planned with skin removal and nipple repositioning, that is the ideal moment to address the upper-pole emptiness. For more fullness on top, a higher-profile implant (a full profile rather than your current Demi gives more upper-pole projection) or a modestly larger size helps &mdash; and it is also worth trying a different, more stable implant brand that holds its shape better over time. One important point: removing skin alone will almost certainly stretch and droop again, so it should not be relied on by itself. Adding internal support &mdash; an internal bra using a mesh such as GalaFLEX &mdash; tends to give much more satisfying, longer-lasting results in post-bariatric or massive weight loss patients and revision mastopexy patients like you, by holding the lift and keeping the volume high in thin, loose tissue.

Semih Yildiz, MD, FEPOBRAS · Answer

The visible photos and your description suggest a lower-pole heavy shape with limited upper-pole fullness, but the implant pocket, skin stretch, and nipple position have to be assessed in person before choosing a profile.

A fuller-profile implant can add more forward projection and may look less wide than a demi/moderate profile at a similar volume, but it will not automatically lift the breast or correct bottoming-out if the skin envelope and lower pole are the main problem. In revision, the key decisions are pocket control, support of the lower fold, how much lower-pole skin is removed, and whether the implant base width matches your chest. A slightly smaller full-profile implant can sometimes improve projection while keeping size similar, but the safest choice depends on measurements, tissue thickness, and how much support your skin can provide.

Full profile or demi for more upper pole fullness? (Photos)

Answers (3)

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