After accepting that I may not receive the results I indeed wanted, what can I realistically expect? (Photos)

My surgeon suggests I use 350CC or greater, moderate saline implants in order to add fullness to the upper poles of my breasts. My surgery is Thursday and I'm just frightened they will appear to large and not even as perky as I wish. What should I expect?

Doctor Answers 12

Realistic expectations ??

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First of all, thank you for your question. I do not believe that your desired result is achievable with your present anatomy.  You show a photo of a primary augmentation, where your anatomy dictates some type of breast lift or at least control of your large areolar diameter.  You have a variation of a tuberous breast deformity, best treated with a silicone implant, rather that saline, as well as a procedure to control further widening of the areolae. This requires at least a periareolar mastopexy with a scar around the entire areola. Cannot comment on size and perkiness, without ball park height and weight numbers.  An in person second opinion by an experienced board certified plastic surgeon may help to guide you further. Best of luck.

After accepting that I may not receive the results I indeed wanted, what can I realistically expect?

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Thank you for your question and photo, Size and shape of breasts can often play a critical role in a woman’s self-esteem. Fuller and bigger breasts are often associated with reproducibility therefore it is a desired condition. There are different kinds of breast augmentation operation types. Breast augmentation can be performed either with breast implants or autologous fat transfer. There are also different types of breast implants like teardrop or round implants. These implants also can be placed under or above the muscle. As you can imagine there are several different options for breast augmentation. The best way to understand which one is more suitable for you is to get a physical examination by a plastic 

Choices for Reshaping, Lifting, and Enlarging Breasts

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Your photos show small, saggy breasts with stretched areolae.  There is also a suggestion of a variation of "tuberous breast deformity", in which you lack enough skin between the lower border of the areola and the fold under the breast where the bottom of your breast attaches to the chest.  A moderately large implant will indeed add overall fullness and especially in the upper cleavage region.  However, you might still have relatively lower positioned nipples and areolae.  Although I can't be sure without a personal exam, I think you would probably benefit from some type of lift to raise your nipples into a much more central position, decrease the areolar width, and lift your breasts more than would be achieved just by placing an implant.

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If you wish a perkier breast augmentation result, I would recommend a periareolar lift with your augmentation.  This would avoid a larger breast with the nipples in the lower pole.  Best wishes, Dr. T

Implant issue

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You can do a baggy test with 350 cc implants to see if you are happy with the volume.  Best of luck...

I think you are unrealistic

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Unfortunately you seem to have a widely spaced breast with some drooping.  This is a mild form of tuberous breast deformity.  I think you probably should go for a second opinion because in my hands only a combined lift with implants will give you anything close to the results you like.  Make sure you see a board certified plastic surgeon by the American Board of Plastic surgery.  Good luck, Dr. Schuster in Boca Raton

Lift with implants

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Hi there. Thanks for the question. Your breasts may appear a bit fuller for the first few months but will settle at about 3 months.  Perkiness can be controlled by adding a lift to your augmentation. The lift involves removal of excess sagging skin and improves the relationship of the breast mound to the skin envelope. 

Good of luck and enjoy your beautiful result. 


End results

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Your goal photos are not unreasonable. Clearly you will require at LEAST a circumareolar lift, possibly more. As to the implant size/shape/profile, I have no way of commenting on that as I don't know your height/bra band width/base diameter of your breasts. If you are not short, a 350 may well be what you "need".

Will I get the desired results that I hope for?

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Thanks for the question.  This decision should always be yours after proper consultation. If you have any doubts, get a second or third opinion.

I would consider doing a doughnut mastopexy as well as a tear drop natural shape implant, or a moderate profile shaped round implant if dimensionally your breast shape recommended this.  This is where a full examination becomes very important.

Good luck to you.

Frank Rieger M.D.  Tampa Plastic Surgeon

Your results will be different than the photos, because

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you are not that woman in the photograph.  Also your breasts are more wide apart that the woman you show as well.  I recommend you seek a second opinion (you may already have) not because your surgeon has provided a plan you do not agree with, but you are uncomfortable.  Wait until you are comfortable with the plan and procedure.
I have done over 5000 implant procedures and over 1600 gummy bear shaped implants...there are many choices for most women to achieve their desired results.

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