36C. How can I choose between saline and silicone? How many CC to get to D? Looking to get fullness back (Photo)

Hi. IMHO you do not need a lift and could have excellent results with just a breast augmentation. I would suggest smooth, silicone gels, partial submuscular placement with implants in the range of 400 CCs moderate plus profile inserted through an infra- mammary fold incision. The augmentation should,lift your nipple a bit without the additional scarring that comes with a breast lift.I am certified by the American Board of Plastic Surgery and have practiced in the"land of breast implants", Miami, for the past 29 years. I encourage you to look up the surgeon you eventually select and make sure they have years of experience in performing cosmetic breast surgery. Furthermore request to see before and after photos of previous patients by that doctor....not a clinic or surgery center. Do your homework......research and verify the doctor's credentials. Have they had problems with the Board of Medicine, disciplinary or otherwise. Any law suits?How about the center, clinic or facility? Are they accredited by a national organization or do they just have State approval. Understand that at the current time, there are three nationally recognized organizations responsible for the highest levels of patient safety, AAAASF, AAACH and JCHO. You owe it to yourself to position yourself for the best possible results but under the most stringent safety regulations, If you have kids, even more so.How about anesthesia? Will you have a medical doctor certified by the American Board of Anesthesiology or a certified nurse anesthetist (CRNA)? Understand that there is no substitute for research. Cosmetic surgery, no matter how simple it may be to the patients, are invasive procedures and as such carry certain risks and complications.I wish you the best on your journey. I hope that the info provided has been helpful. Should you require any further clarification, do not hesitate to contact our institute. I answer all questions personally, not through patient coordinators or other marketing individuals.In our office we use TouchMD which is a web based program in which patients have the ability to load their picture unto the program. I then evaluate them and can actually draw on the picture to show a potential patient where the incisions would be located and how the procedure is to be realized. It's all done to comply with HIPPA which is the federal law that protects the patient's medical information. Look them up. Good luck, Dr PG

Hello MrsTummy. Thanks for your question and photos. Thanks for posting photos of women with similar anatomy and think this helps too and to see their results. As far as saline vs silicone, I currently use 1 saline breast implant for every 99 silicone breast implants. That's 1% of patients choose saline. It seems consumers want the natural feel and look of silicone more than firmness with saline. As far as sizing in my practice, this is how we do it:1) My philosophy includes guiding patients to explore reasonable options for breast implant size, usually two to three similar sizes, which allows the patient to visualize how different volumes affect their breast cup. 2) The best guide for a final breast implant size recommendation is derived using measurements from the patient’s own breasts and chest. 3) When measurements are considered then options for sizes can be presented. 4) I use the Mentor Volume Sizing System of breast sizers to demonstrate how these different volumes will look on a patient’s body. 5) This methods offers good reliability and is simple to use, but is not perfect.Your best resource now is your PS. Best, Dr. ALDO.

From your photos - it appears that you are a candidate for an anchor lift- in order to lift your breasts and make them perkier. Implants do not "lift" breasts-- they only make it larger... I would NEVER put an implant alone in these breasts. I would ONLY perform an anchor lift possibly with implants no larger than 325cc gel under the muscle. Your nipples point down and only a lift will get it into its best position. 

Silicone gel implants are generally aesthetically superior to saline. The only disadvantage is that they cost a bit more. As regards size there good sizing systems that will allow you to pick very precisely the volume of the implant that will get you to the cup size you desire.

Your desired appearance can be achieved with a implant and a dual plane breast augmentation. I have many patient that do not want the scarring of a breast lift. It is difficult to determine the number of cc's that will be required but it will be approximately 300- 400 cc.   Remember the larger you go the heavier the breast becomes and this may ccause more sagging. I also think an implant with a higher profile will help with your lift. 

As an over the internet responder I must advise in person opinions are better. My guess is a full lift would be needed. as for saline vs silicone that is a personal decision. I prefer silicone - more natural feel, lees wrinkling chances, but increased costs. The # of cc's for D cup in your case would be 450 to 550 cc moderate profile + implants.. Good luck...