Petite, Naturally Large Breasts for my Frame, Getting Lift and Implants. What Size? (photo)

if a woman wears a size 36 AB bra and would like
to be a C cup, which is the average size that women wear and the average size
bra that is sold, she needs a volume of approximately 350 to 390 cc to make
that change. This becomes less if she's wearing a 34 bra, because it has a
smaller strap size and the cups have a smaller diameter. A smaller diameter
implant would then be a volume of approximately 300 to 350 cc. In the same way
if she was more petite, maybe a double zero or size one and wore a 32 AB bra,
then to become a 32C cup she would only require about 250 to 300 cc. since you are already 32 DD you be at least 2 cups fuller . this will be a big implant for you.

If you are size 32 DD and want tro be a G that requires 2 cup size increase, which would be about 200 cc of implant.  I recommend you undergo a lift through a circumareola approach leaving only a circumareola scar.  With this technique your breast tissue and areolas can be lifted and implants placed high on the chest wall to give you the projection you desire.  You may be a candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.

Best Wishes,

Gary Horndeski, M.D.

There is not a general rule of thumb or objective criteria to implant selection. The size of the implants are based on a combination of a patient's goals
and objectives and her anatomy. In order to provide a natural looking
augmentation, the surgeon needs to evaluate many factors including soft
tissue coverage, skin laxity, chest wall width, breast imprint width,
the shape of the breasts and relative level of constriction to ensure
that the breast implants are appropriate for your body. Consult with 3
experienced and expert board certified plastic surgeons to understand
your objectives.

I consider two factors when selecting implants for my patients:1.Dimensional planning2.Gel Implant Sizing systemDimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look. Hope this helps.Best wishes,Dr. Basu

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

In a case where you have a large amount of breast tissue for your frame, but it is out of place (saggy), consider a breast lift first. If you are still wanting a bit more volume afterwards, then the consideration of implants is warranted. However, your breasts have already shown a propensity to stretch and sag. Adding large implants may give you a look you want this year, but is more than likely to lead to bottoming out, stretching of the skin, and multiple revisions as the years go by.

Your have chosen a patient with implants only and you can not have the same results since your breast is different than the patient in the picture. I would offer lift first and augmentation later since you start with a large breast. The concern is that your breast will slide off the implants.

The goal photo you show are quite large.

To choose a size that you see as a goal, you can try on implants, use some of the imaging software that some surgeons have, and/or look at photos in some of the data bases where you can find patients of similar height and weight and see what size implants gave results similar to your desire.

Without an in person exam I could not say for sure if I thought it would be safer to do this in two stages, but I would ask your surgeon's opinion on that.

Thanks for your question and for the photos. 

Thanks for the question and posted photos. The desired result has a large implant without a lift!!! You might consider staging the operation to full Lift first than a second operation of large implant. Just a thought. 

If one of my patients wants to be really big like you I usually do them in stages.First the mastopexy then the aug.Soemtimes it is difficult to do a lift and turn around and put in a large implant.