Can I really not go to a full D?

I am a 31 year old mom of 2, I'm 5'2" and weigh 120. I had a consultation back in June in which I discussed that I want a Mommy Makeover. I used to be a full C then after breastfeeding that has dropped me down to a B with horrible sagging. This surgeon told me he can put 339ccs, moderate silicone unders and that would put me at a full C. He said it was not possible to achieve a fuller D or a small DD without a second surgery. I just want to be a full D, judging by my picture is is possible to obtain?

Doctor Answers 19

Breast augmentation and lift candidate, some advices:

Thank you very much for enquire.
After having analyzed all the information and photos provided to us, I realize that you have very sagging and small breasts. In this regard, you need volume (implants) and projection (the lift): Breast Augmentation w/Breast Lift.
I recommend you to use microtexturized highly cohesive silicon implant ("gummy bear" implants), with high projection, and 450ml will be excelent on you, to fill the breasts properly.
Finally, to perform the breast lift I recommend a Periareolar Round Block Breast Lift ("Benelli mastopexy"), which has an unnoticed scar around the areola, and if we see (in the surgery) that we can't obtain adecuate projection just with the Benelli Lift, we have to perform a "Lollipop breast lift".
Dr. Emmanuel Mallol Cotes.-

Dominican Republic Plastic Surgeon
4.7 out of 5 stars 147 reviews

Desired cup size

Thank you for your question.  Rather than focus on a cup size, I suggest you communicate a desired appearance.  This is best accomplished by sizing in your surgeon's office or through the use of a system like Vectra.   An implant of 339 cc in addition to your natural breast tissue may produce the size breast you desire.  Since bra manufacturers size their bras differently, one person's idea of a D cup may be different than another.  Hope this helps.

Full D or Bust

Your question brings up several topics all of which must be addressed and understood.

D CUP ASPIRATIONS - While most discussions about breast sizes use bra cups as a comparison and communication tool, doing so is woefully inaccurate because a cup size is NOT a real measurement applicable across all bra manufacturers. So, unless all women use the SAME bra comparing cup sizes is notoriously inaccurate as a comparison tool AND As a predictive tool in saying how large a certain implant would make a given breast. 

CORRECTING THE SAGGING BREAST - A sagging, deflated breast is unattractive and should be addressed before focusing on cup size. (Large deflated sagging breasts are hardly more attractive than smaller sagging breasts of the same appearance. So performing a Breast Lift (MASTOPEXY) should be done with addition of volume (Breast Implant) to reach an ideal compromise of volume, projection and perkiness (out of a bra). 

CHOOSING THE IDEAL IMPLANT - ALL breast implants ripple and crease - some more than others. To avoid seeing such ripples, it is essential to pick an implant which is completely covered by your breast tissue. In this way, your tissues cover the ripples allowing for natural results. IF the width of the chosen implant is wider than the available breast tissue coverage, the ripples WILL be visible and palpable. So, instead of focusing on volume (cc's) you should be shown the 10 or so implants (with a variety of shapes and volumes) which could be placed under YOUR breast tissues and produce a nice result. A better way, is to have 3D imaging (VECTRA by Canfield) which can SHOW you what each implant MAY look like in your breast and the overall breast from every possible angle. (No buyer's regret and No disappointments).

In summary, you have the makings of GREAT looking breasts if you understand the thinking and planning behind it.

Peter A. Aldea, MD
Memphis, TN

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 101 reviews

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Likely Possible

The goal of mastopexy (breast lift) augmentation is to create an aesthetic breast with the size, shape, and projection that is desired by the patient. During a consultation, measurements of the breasts are used as a starting point to recommend a breast implant.  The decision on size, shape, and position of these implants is based on the patient’s anatomy and the type and size of the implant and patients preferences. The type of lift is determined by your current nipple position and the quality of your tisssue.

Based on your pictures, a dual plane, smooth, round, silicone implant with a lollipop plus lift would likely give you a nice result. Achieving a full D would appear to be possible. 

See the link below for more info on breast augmentation and breast lifts after breast feeding.

A detailed examination will help delineate the best surgical treatment. In office sizing and digital three-dimensional simulations can help guide your implant choices. A second opinion with a plastic surgeon certified by the American Board of Plastic Surgery would be the next best step.

Size you would like to be.

It is very common for some surgeons to dictate or tell the patient what size they should be. The is a set up for an unhappy patient. There is no way to read the patients mind and determine the exact size the patient thinks they should be to give them the ideal look they would like. That's why it is so important for the patient to try on sizers or perform the rice test to help determine what that perfect size it is they think they want. Then it's the doctors job to determine if he can make that size work for the patient and if not back down. But too many time I see physician pic what they think is the ideal size while not listening to the patients concerns. I think you can absolutely get to the size you want. I hope this helps

William J. Hedden, MD
Birmingham Plastic Surgeon
4.8 out of 5 stars 281 reviews

It is indeed possible.

Thank you for your question. Without getting into a discussion of specific implant sizes, which really cannot be done without an examination in person, you first need to know that the most important aspect of your breast enhancement is a breast lift (mastopexy) that will reposition your nipple/areola complexes in the right location, and reshape your breasts to their optimal aesthetic shape. You can then effectively have an implant inserted that will take you from the probable B/C cup that you would be WITHOUT implants, to the D cup you are hoping to be for your final result.

If you have uncertainties after your first consultation, you should schedule a second consultation with your original plastic surgeon. If you remain hesitant, seek a second opinion consultation with a board certified plastic surgeon experienced in breast enhancement surgery whose aesthetics align with those of your own as you review their before and after gallery. Best of luck to you. 

Ram Kalus, MD
Mount Pleasant Plastic Surgeon
4.8 out of 5 stars 20 reviews

Breast size

The first thing  I discussed with patient's is at the end result is visual.  I do not discuss cup size or focus on it.  Breast cup size is very subjective.  I certainly think you could go larger than the 339 cc volume .  I will also him discussed mastopexy, breast lift.

Steven S. Carp, MD
Akron Plastic Surgeon
4.5 out of 5 stars 28 reviews

Size of Implant

It is possible to achieve the size you want. any procedure to enhance the size of your breast will need to be accompanied with a procedure to elevate your nipple/areolar complex.

Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Breast lift with implants

Hello and thank you for your question. You are a great candidate for a breast lift with implants.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.  

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 67 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.