Best implant to look full but not heavy? Can I get labiaplasty at the same time? (photo)

Patient concerns regarding the appearance of their breasts can typically be divided in two pools: volume, ptosis (droop). The procedures to address these issues are as different as the issues themselves. However, these concerns are not mutually exclusive. Many patients, whether they are aware or not, will benefit from both.
There are two factors which can help to answer the question of which surgery will deliver the most satisfying result: mastopexy, augmentation or both. Patients must first consider the position of the NAC (nipple areolar complex i.e. the pigmented portion of the breast) as it relates to the inframammary crease. If the nipples are at or below the level of the crease the patient may benefit from a lift or mastopexy. The breast lift is designed to elevate sagging breasts to a more youthful position. It also helps to reshape and tighten the skin of the breasts. This is typically accomplished via a periareolar (around the nipple) incision with or without a vertical incision.
Mastopexy is an effective way to address sagging breast, however, the changes which accompany weight loss or pregnancy can also decrease volume of the breasts. When a woman wants the volume restored, or increased, a breast augmentation will also be needed in conjunction with mastopexy. Augmentation can help restore the volume loss which is well known to women following children. There are a number of options available to women considering augmentation ranging from size and implant type to access incision.
A breast augmentation alone may also be appropriate if ptosis is mild. If the patient is comfortable with the natural appearance of the breasts but desires them to be larger, a breast augmentation alone is the right procedure. Augmenting significantly ptotic or sagging breasts tends to magnify the problem. In these cases, a mastopexy performed in conjunction with an augmentation is preferred.
Based upon your photos, you would likely benefit from a lift in conjunction with an augmentation. However, if you are willing to accept a slightly lower nipple position the added scarring can be avoided. As for sizing, the best advice that can be given without measures/exam is to respect your breast width when choosing.
There is a procedure for every problem. To determine which technique is right for you, consult with a board certified plastic surgeon Patient should discuss their concerns with their physicians in order to make an educated decision.

Hello! It's great that you're planning ahead for your breast augmentation. Based on your height (5’4), weight (145 lbs), and previous breast size fluctuations due to breastfeeding, you may benefit from implants in the range of 275cc to 375cc for a natural yet full appearance. The final size choice depends on your desired look, body proportions, and tissue elasticity.Since you mentioned that you were borderline for needing a lift but are comfortable with your nipple position, a breast augmentation alone may restore volume, but it won’t correct sagging if present. Your surgeon will assess whether an implant alone can achieve your goal or if a subtle dual-plane placement may help improve upper pole fullness.Regarding labiaplasty, yes, it is often performed in combination with breast procedures. Many patients choose to combine procedures to minimize recovery time and anesthesia exposure. However, this depends on your surgeon’s preference, surgical time considerations, and your overall health. Make sure to discuss it during your consultation for a personalized plan.

Dear taylorjordanne2,

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
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

According to your pictures, I think you will need breast lift also. But if you absolutely against it, I would like to say with the slightly bigger implants you can achieve fuller and natural looking breasts. With careful planning there is no reason to look heavy. You can get labiaplasty at the same session

Thanks for your questions and pictures. It does appear that you can get a good outcome with a breast augmentation. A lift may be beneficial but not necessary. Your wish pictures do show results with implants positioned high. The best way to determine the correct size of implants for you will be based on specific measurements taken during your exam as well as based on your desired outcome. Implants that are too wide for your frame can give the "heavy" look. Finally, a labiaplasty can be done at the same time as a breast augmentation safely. Good luck!

Your nipples are located below your breast fold, and the wish pics you attached show significant fullness in the upper portion. For this reason, a lift would be recommended. Labiaplasty can be performed at the same time if it is deemed safe to do so by your surgeon. For implant sizing, it would be a good idea to try on sizers at your surgeon’s office, in the range of sizes recommended by your surgeon. These are implants you can fit into your bra to see how you may look and feel after surgery.

Thank you for your question. It is true that sometimes a larger implant on someone who's torso is rather short can make one look heavier. This of course is subjective and it is hard to put a volume on that. In general when asked this question I often seem to answer in the high 400s and above but there are many factors that go into this including how large ones breasts are preoperatively. If there is some descent of the breasts and trending towards possibly requiring a lift, one does need more volume if one is planning to avoid a lift. My patients tend to choose in the higher 300s or low 400 when faced with this scenario. Discussed this with your surgeon. Perhaps he or she will have 3D imaging and you can get a better idea of what these volumes look like.

The technique I recommend is a breast lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Thanks for your question! Yes, you can do a labiaplasty in conjunction with a breast augmentation. In my opinion, you will have a very "heavy" look unless you commit to a breast lift. In the wish pic, that patient isn't droopy per se. You are. I would encourage you to schedule an in-person consultation with one or more breast specialists in your area. Good luck!