Why Do I Look Flat Chested with a 750cc Implant?

Will project further than moderate profile ones, but they will tend to be softer and flatter than saline ones.  The first weeks/months after implants will see definition of the breast implants into softer more natural looking and separate breast mounds.  Do not be in a hurry to start changing things until you are through healing and your skin has had time to conform to the new implants.

There are many factors which contribute to the shape of a reconstructed breast.. 750cc High Profile silicone implants typically give good projection, however, the surrounding soft tissue can mask this projection if not properly shaped. In your situation you state your expanders had 850cc. The volume and shape of those expanders would definitely give a different look than the 750cc HP implants. Expanders always appear more projecting because they are essentially fixed devices. They are firm and do not change shape with position. In contrast, the implants are soft and deform to the weight of the soft tissue envelope and change their shape based on your body position. This leads to a different shape of the breasts following exchange. I often tell patients that the expanders give the look of implants in a supportive bra. One option for improved projection would be a change to Natrelle Style 45 implants as these have significantly more projection.

Many women have excess skin and fat underneath the arm which is not removed after a mastectomy. This soft tissue can create the illusion of a wider, less defined breast in a reconstruction. Liposuction and skin contouring will improve this appearance and give lateral breast definition. In addition, the actual mastectomy skin flaps themselves need time to contract around an implant. Particularly when the expander is overfilled in comparison to implant size, the mastectomy flaps can take several weeks before they form fit around the implant. Finally, a loss of the inframammary fold (the sharply defined crease under the breast where the breast meets the chest) can occur during the mastectomy and lead to poor definition of the bottom of the breast. There are several techniques that can improve this fold definition and improve the overall contour of the reconstructed breast.

Even with all of these issues addressed, some patients simply look small with the large implants. In these cases, autologous tissue (TRAMs, DIEP flaps) may be a better option.