How Do I Pick Implant Size While Avoiding Future Sagging?

I am 5'11 and 175 pounds. I have already consulted with a board certified PS and I am scheduled for BA in 3 weeks. My doctor recommended under muscle mentor silicone implants. He advised that to even out some asymmetry I have he will place one 500-550 implant and one 650-700 implant. . I basically want my breast to be even. I tried on the implants and they looked proportional to my hips. I do not mind some droop but I cant help but think they will be very saggy. Should I go smaller to avoid sagging?

Doctor Answers 11

Under the muscle breast implants sag less

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Thank you for your question. Your plastic surgeon is and the best position to advise you. I can say however that placing the implant under the muscle is the best way to avoid future sagging.As a general rule larger implants can sag more.

Implant Selection Process

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In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.
Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

Paul S. Gill, MD
Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

Selecting Implant Size

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Thank you for your question. When placed under the muscle, sagging is not as common, and your Board Certified Plastic Surgeon can direct you into a size that meets both needs of avoiding a sagging appearance and a size which fits your physical structure. I hope this helps.

Vivek Bansal, MD
Danville Plastic Surgeon
4.9 out of 5 stars 26 reviews

Avoid future sagging and revision

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You can avoid future sagging by using a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  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.  Through the same incision, an implant can be placed in the retro-pectoral position.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall gives maximum anterior projection with a minimal size implant.  Smaller implants are more stable long term, look and feel more natural, less likely to ripple or have complications that need revision.  Implants as large as 500 to 700 cc’s will not fit retro-pectorally, will extrude inferiorly and laterally from muscle compression and require revisions.  I am glad that you are thinking about future problems because 500 to 700 cc implants  require additional surgery.


Best Wishes,


Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Implant size has little to do with subsequent breast sagging.

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The capsule forms around a breast implant services a 24/ seven bra. Only occasionally one implant sagging of its own accord. Your native breast tissue can sag but generally not the implant.

Large implants

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I do many revision surgeries on patient who have had large implants placed by other surgeons.  In these cases the most common reason for the revision is sagging and lateral displacement (implant go to side when you are lying down).  Sometimes to get a larger implant to fit, the surgeon needs to free up important anatomic attachments that help keep the implant in place.  In summary, without breast measurements and an exam, it is impossible for me to counsel you are your particulars; but larger implants in my  experience have EARLIER drooping and lateral displacement than smaller implants, but all implants may droop with time.  

Sagging and breast implants

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Sagging of the breasts after a breast augmentation is related to your pre-existing anatomy and not necessarily to the weight of your implants.  If you have sagging breast and thin, atrophic skin with not much skin elasticity then they are going to sag after surgery.  Photos and an exam are needed to give you a more definitive answer.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Will my breast implants sag?

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Hard to tell without an exam, but typically the larger the implants the more weight and the higher risk of sagging...all that said you are a taller woman and proportionally these may not be large implants...discuss with your PS

Jonathan Weiler, MD
Baton Rouge Plastic Surgeon
4.9 out of 5 stars 93 reviews

What size breast implants to avoid sagging?

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Because your height and weight, these implants will probably look good on you, but the weight of them will be an issue in the future.  I have noticed over the past 20 years that anything over 350cc has a higher chance of causing breast droop over time.  In addition, you need to be very cautious if you ever do workouts that include your chest (pectoral) muscles including yoga or Pilates.  Pec flexion will cause the implants to drift laterally and inferiorly over time.  You can work your upper pec muscles, but try to avoid working the central and lower pectorals.

Implant to avoid sagging in future.

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The saging is a funciton of your skin quality and implant weight (size). The larger the implant the more likely it will be to drop. Its hard to answer your quesiton without examining the quality and thickness of your skin.

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.