Closer together and very perky - Are my Breast Augmentation Expectations Realistic?

I have very small breasts (34A) that have a downward curvature from my sternum. However, with breast augmentation, the results I'm looking for would be closer together and very perky. I am not worried about keeping my natural shape because I don't particularly care for it. With my natural shape, would results like these be realistic and/or achievable? (First 2 pictures are me)

Doctor Answers 19

Breast Implants - Implants Alone? Will My Result Look Like Either of the Following?

Hi LilyRose19 in Spokane, WA,

One of the hardest things to do is to look at someone else's post-op photos and to try to get an idea of what you'll look like based on that.  Each person is different, and you can only judge a given post-op result when you compare it with its own pre-op appearance.  Similarly, you can only look like you with implants - not like anyone else with implants.

It is difficult to make an absolute recommendation based on these photos alone (indeed, you really need to make all decisions in consultation with a plastic surgeon who has examined you).  I think you would get a nice result with implants alone.  However, you have a small degree of ptosis (sagging) in the sense that your nipples are a little low.  You may want to discuss having a superior crescent lift (which elevated the nipple/areola a bit) in addition to the implants.  Neither that nor any other procedure is necessarily perfect or advisable for all patients, but that might be a compromise procedure that gives you both an increase in size, and lifts your breasts just a bit.

I hope that this helps, and good luck,

Dr. E

New York Plastic Surgeon
5.0 out of 5 stars 125 reviews

Expectations Following Breast Augmentation

The key to answering this question lies partly in what the pre-operative photographs look like for the example you provided. The closer those pre-op photos resemble your breasts the more likely your result will be similar. The use of before & after photos may be helpful to convey the size (e.g. larger or smaller) and shape (e.g. round, full, natural, mature) a patient is interested in achieving. My experience has been that when patients bring in before & after photos, these photographs often show a pre-operative breast that is much different than the breast that patient has. It is then necessary to explain that, compared with the photograph, a different end result will be achieved.

Results following breast augmentation are some combination of at least the following pre-op factors: breast size/volume, tissue elasticity, tissue excess, nipple position, inframammary fold position, volume of implant used, pocket placement over or under pectoralis muscle. Since every woman’s breasts are different each woman experiences her own results based upon the above factors. Breast augmentation increases the size of the breast shape you already possess.

If implants are placed under the muscle they do not affect cleavage because the medial insertions of the pectoralis muscle are left intact and this therefore represents the medial extent of the pocket dissection. The only way to address/improve cleavage with an augmentation is to place the implants over the muscle. This, however, means that the implants have less tissue covering and are probably at increased risk for capsular contracture. The space between your breasts does not seem excessive, but instead, within the range of normal and should allow a nice result even with a sub-pectoral placement. The use of a pushup bra will usually enhance cleavage to some extent as well.

I would guess that the woman depicted in the “after” photos has a tighter pre-operative skin envelope and a slightly rounder shape than you do. Her starting nipple position is also likely a bit higher than yours. Your result may not be quite as perky as hers, and you may need to consider a small breast lift to place your nipple-areolar complex in a slightly high position over the breast mound.

Best wishes, Ken Dembny, MD

Kenneth Dembny, II, MD
Milwaukee Plastic Surgeon
4.9 out of 5 stars 34 reviews

Realistic breast augmentation expections

You appear to have thinner tissues and certainly have lower nipple position than the post-augmentation photos that you have shown.  As far as I can tell from your photos, you should expect to obtain a very nice improvement from breast augmentation, although I doubt you will look very similar to the photos you selected.  How close together implants will reside ("cleavage") depends on several factors, not all of which can be controlled...these include the shape of your ribcage, where your pectoral muscles insert in the central portion of your chest, the size and diameter of the implants selected, how your pockets heal, etc.  Because of your thin tissue, you need to have your implants placed under the pectoral muscles to hide visibility of the implant edges and possible wrinkling, and the central portion of the muscles must not be divided in an ill-advised attempt to create "cleavage" as it could lead to wrinkling and a host of other problems.  Also, without examining you and measuring your nipple position, I cannot tell for sure whether you will have a good result from augmentation alone or whether you may need a minor "periareolar" lift.  Although you may not need this, your nipples will be lower than what you see in the results you posted.  Rest assured that you are a good candidate for a breast augmentation, but you must have realistic expectations as to what can be achieved in light of YOUR anatomy.

Robert M. Grenley, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 87 reviews

Perkier contour and cleavage

You may find that an implant with a smaller base width to make your breasts project more forward from your chest wall and body can be sufficient, making a breast lift unnecessary. Consider the Allergan Inspira TruForm 2 implant and an areola reduction.

Post-operative cleavage will depend on your pre-surgery cleavage. You have wide-set breasts, which means you'll probably continue to have wide-set breasts after surgery. However, while you may have a bit of improvement, it may not be as much as you want. Unfortunately, your surgeon can only do so much to give you cleavage before it looks abnormal, since the implants have to remain centred underneath your nipples.  

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 179 reviews

Realistic Breast Augmentation Results

It is always difficult to match exactly another patient's result with a breast augmentation.  I do think, however, that it is possible in your situation to achieve a result which is comparable to the photo of the model you provided.  Show the photo to your plastic surgeon during your initial consultation and ask her/him if this seems feasible.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast augmentation

Your nipples look a little low right now. So afterwards the nipples would most likely still look  a little low. Doesn't mean they won't look good but maybe a little more like the second example your showed and not the first.

David E. Kim, MD
Beverly Hills Plastic Surgeon
4.7 out of 5 stars 99 reviews

Are my Breast Augmentation Expectations Realistic?

That is the question! Are your expectations realistic comparing the other photos to your?? Hard to advise but I think you should expect a less than exact result compared to those photos. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Breast augmentation -getting it right the first time

If you ask 10 different surgeons you are going to get 10 different answers. I think you will be happier with the look you have after breast augmentation because you will look closer to the photo of the results you want. However without seeing the before photos on the other persion or knowing specific breast measurements in common before surgery it is impossible to say how close your end results will be, even if you place the same size implants.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Aaron Stone, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast augmentation expectations

You should be able to get a result of  similar size and similar sternal relationship. You will not be as tight or  perky appearing. The nipples would not appear as high as the first "after" example you show. You are likley to get a more natural result than the two examples. I would not recommend a lift. Good luck

Ernest D. Cronin, MD
Houston Plastic Surgeon
5.0 out of 5 stars 2 reviews

Breast Augmentation expectations

You have shown us good photos of yourself and two different post op patients. I would guess that you could expect to look as good as the first set of post ops. Her results are better than those in the second set from my aesthetic viewpoint. I think it's because the implants in the second set look a little too large.

Hugh McLean, MD
Mississauga Plastic Surgeon
3.8 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.