Which surgeon or which implant size/profile should I choose? Totally different opinions. (photo)

I want to replace my 300cc saline round implants with silicone implants. Goal- Small D (not too round like balls) and proportionate with body frame. Stats- petite, 5'5, 120lbs, waist-26.5, hips-36, minimal breast tissue, breast diameter -12. Three surgeons suggested these options: PS#1- 400cc to 500cc HP, PS#2- 275 cc or 300 cc mod/mod + profile, PS#3 - 480 UHP. Which one will give me my desired goal?

Doctor Answers 4

Breast Augmentation with Mini Ultimate Breast Lift(TM)

Unfortunately, you have not told us your bra size. If you are 32 or 34 each 100 cc’s of implant corresponds to 1 cup size change. If you are 36 or 38 each 200 cc’s of implant corresponds to 1 cup size change. From this, you can compute the volume required to achieve your desired goal. Your breasts are deformed and flat laterally. You will need the pocket enlarged inferiorly or implants raised higher. I recommend a new technique called Breast Augmentation with Mini Ultimate Breast LiftTM. Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant. Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it. 22% of women who undergo breast augmentation alone require revision within 2 years because they are dissatisfied with the result.

Best Wishes,

Gary Horndeski, M.D. 

Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

What to know about going with larger implants

First, in general larger implants are more likely to cause problems in the long-term. If your base diameter is 12 cm, then any increase in size would need to be high profile, which is more of a round fake look. The photos appear to show some constriction on the bottom of the breasts so you should ask about how that contour might be improved. There are no simple answers about what type of implant and size is best, only trade-offs.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 52 reviews

Selecting breast implant size / style

I believe in the dimensional planning approach to breast augmentation, which matches implant diameter to your chest wall.  Considering three different profiles of round implants, as you move up in projection (moderate plus to high to ultra high) you increase the final breast size, but also increase upper pole roundness at the same time; moderate plus profile implants will generally look more natural than ultra high profile implants.  Determining the best implant size and profile for you should involve extensive discussion with an experienced board-certified plastic surgeon, taking into account your chest wall dimensions and desired outcome (remember that bra size is dependent on bra manufacturer).  For some women this means accepting either a smaller final breast size or some additional upper pole roundness.

Your "wish pick - size & shape" is a photo of Kate Upton, who has large, natural breasts (no implants); therefore, the ability to achieve her size and shape would depend upon your chest wall dimensions and the sizes and profiles of implants appropriate for you.

Best wishes.

Craig S. Rock, MD
Houston Plastic Surgeon
5.0 out of 5 stars 29 reviews

Which surgeon or which implant size/profile should I choose? Totally different opinions.

Thank you for the question and pictures.   Despite good intentions, online consultants will not be able to provide you with  meaningful specific advice.  Ultimately, in person consultation with well experienced board-certified plastic surgeons will be necessary. Careful measurements, dimensional planning, and careful communication will be key.

Generally speaking, the best online advice I can give to ladies who are considering  revisionary breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your   desired goals  with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.  The use of computer imaging may be very helpful during this communication phase.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery. 

Based on your current photographs, adjustment of your breast implant pockets may be an important part of the revisionary breast surgery as well.  I hope this, and the attached link, helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 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.