I'm a 36 year old, mother, 5'9", 130lbs. Could you please recommend me what would be best for my breasts? (photo)

Question

I was at doctor last week and he recomended me under muscle : - Mentor CPG™ Implants 322, Cohesive III™, Medium Height, Moderate Plus Projection, 330 or 375 cc or - Motiva Full 350 cc. Could you please recommend me what would be best for my breasts,according to the dimensions I applied for a well-formed and tight bust. I would like to know: Type of implants (round,anatomical ), model, volume,width,height,projection and etc. Kind regards, Tanya

Mariam Awada, MD, FACS · Answer

I appreciate your question and your desire to make the best choices for your implant procedure. With many options available to you, the process can seem overwhelming indeed! Fortunately, if you are working with a board-certified plastic surgeon experienced in all types of breast augmentation, you will have all the support and advice necessary to make the decisions that will ensure your desired results. In addition to the type of implant, saline or silicone, your surgeon will help you choose the size, profile and placement that will work best for you. This is best accomplished when you have a personal assessment in your surgeon’s office, so factors can be considered carefully and expectations discussed. Good luck to you with your augmentation decision.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.
  
The size of implant is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.
  
Silicone will give you a fullness at the top (upper pole fullness).
  
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.
  
Anatomic gummy bear implants might be a good choice to give you volume.
  
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
  
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.
  
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 and restorative breast surgery.
  
Best of luck!
  
Dr. Schwartz
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation.  The sizes you mention in the mid-300s are likely reasonable for you.  The size, profile, and shape 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.  This entire surgery
can be performed with a small incision technique.  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.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Anthony Barabas, MBBS, FRCS (Plast) · Answer

In the U.K. most surgeons use silicone cohesive gel implants, either round or anatomical, and above or below the muscles according to the look you are after. The degree of cohesion of the gel does determine the firmness and shape of your breasts afterwards.You really need a face to face consultation and examination to work out what is best for you, but from your photos I think you will have a great result from round breast implants, and between 300-400cc should suit you fine.

Daniel Barrett, MD · Answer

Dear stefanova3004,breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Jonathan J. Staiano, FRCS (Plast) · Answer

Hello Stefanova,I think the most important thing to get right is the choice of your surgeon.  There is no substitute for an in person consultation and it is very difficult to give advice about the specific choice of implants over the internet.  I have done a short video below and you can register for my webinar on my website where I talk about the issues when choosing breast implants.If you are uneasy about the implant choice, then I would encourage you to go back to your surgeon to go over things or to look for another opinion.  I think that most plastic surgeons realise that it is very common for patients to get several opinions, so you should not hesitate to see other surgeons if you wish.Make sure you choose a fully qualified plastic surgeon with the letters FRCS(Plast) after their name and this is something that I go over in detail in my book 'Never Accept A Lift From Strangers - how to choose the best plastic surgeon for your cosmetic breast surgery'.Good luck.

Reza Nassab, FRCS (Plast) · Answer

Thank you for your question and photos.  You would be a good candidate for breast augmentation.  Given that you are slim I would also suggest going under the muscle.  The breast dimensions will provide some idea about the size of implant that can be used.  The 300cc range would be suitable for you.  It is important to discuss with your surgeon the desired look and shape you would like to achieve.

Manuel Ventura Gonzalez, MD · Answer

The type and size of implants that you want to obtain will determine you with the plastic surgeon of your choice, that according to your figure you will be told which implants fit your body well, the shape can be tear or round, Your surgeon will recommend.
The teardrop-shaped implants are contoured and considered more anatomical. They are shaped like a natural sinus and create an inclination when placed over the chest muscles. Although these are more natural looking breast implants, you will need an experienced plastic surgeon to ensure they are properly positioned.
  
Round breast implants are used to give women a "Victoria Secret" appearance. Round implants are the most common breast implants as they provide a fuller and fuller look as well as a better cleavage. Certain types of round implants can also improve breast projection. However, some women feel that round implants look too artificial.
  
Always To Serve You, Dr. Manuel Ventura 
  
Certified, Medical Research Institute of Plastic Surgery in Sao Bernardo do Campo, Sao Paulo, Brazil.

Tom J. Pousti, MD · Answer

Thank you for the question. 
 Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.
There are several steps taken to select a specific size/profile breast implant for a specific patient. These steps will vary from one practice to another.  I prefer to have a wide selection of implants (all profiles) available in the operating room. I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison. I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible. 
Ultimately, careful selection of plastic surgeon and careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
Generally speaking, the best online advice I can give to ladies who are considering 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 are 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 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. For example, I have found that the use of words such as “natural” or "C or D cup” or "well formed and tight bust" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
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, after the use of temporary intraoperative sizers.
In your case, my best advice: more communication. It will definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.
I hope this helps. Best wishes for an outcome that you will be very pleased with.

M. Dean Vistnes, MD - Account Suspended · Answer

Your best bet when you are trying to decide on implants is to try on sizers of the exact implant you are considering inside a very tight sports bra. This will give you a close idea of what you will look like. More importantly the dimensions or width of the implants need to match and fit your frame and body. If you are working with a board certified plastic surgeon with an expertise in breast augmentation he or she should be able to help you with this in their office. Good luck!  
Dean Vistnes, M.D.
Vistnes Plastic Surgery 
San Francisco Bay Area
#drdeanvistnes #breastaugmentation

I'm a 36 year old, mother, 5'9", 130lbs. Could you please recommend me what would be best for my breasts? (photo)

Answers (10)

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