Deciding if 300cc will achieve my outcome? (Photo)

Question

Hello..…I’m 52 years old and 5’ 2 inches and weigh 117 pounds..…I’ve had 3 children via C-section and lost around 20 pounds in 2022..…which I have maintained at 117 for the past few years. I went to get a consultation and was slightly overwhelmed and underwhelmed since my surgeon did not elaborate or give an opinion? He suggested either 265cc or 295cc..… I’m also currently wearing a 34b..… I want an outcome where I am fuller on top and hopefully, less droopy..…yet still natural..… I want to look fuller but not like I had plastic surgery..… i am leaning towards the 300cc but still anxious that they will be too big? My surgeon is recommending I get the gummy silicon out moderate to high profile..…and dual procedure..… Will that give me what I want outcome wise: fuller on top, less droopy and still natural looking?

Leila Kasrai, MD, FRCSC · Answer

The size recommendation may be able to achieve your goals. However, due to the shape asymmetry you may need to consider a lift on one or both breasts (depending on whether your nipples are located at or below your breast fold.) This would give you the fullness that you’re looking for.

Emre Guvercin, MD, FEBOPRAS · Answer

Based on your height, weight, age, post-pregnancy changes, and current 34B with mild droop, it’s important to be very honest about expectations.Augmentation alone (dual plane with a 265–300 cc implant) can add volume, but it will not reliably correct droop or create upper-pole fullness in a natural way at 52. An implant can fill the breast, but it does not reposition breast tissue or the nipple. This is why many patients feel “bigger but still droopy” after implant-only surgery.For your goals &mdash; fuller on top, less droopy, natural, and not obviously surgical &mdash; a better strategy is:Lower to moderate profile Motiva Round implant (rather than moderate–high)Combined with a conservative lift (Push-Up Lift concept) that reshapes and repositions your own tissueThis approach:Uses your tissue for shape, not just implant projectionAllows a smaller implant to look fuller and more naturalAvoids the tight, “implants-doing-all-the-work” lookGives upper-pole fullness without over-sizingRegarding size: the difference between 265 and 295/300 cc is subtle, especially when a lift is added. With proper reshaping, 300 cc will not look too big on your frame when paired with a lift and a lower–moderate profile implant.

Donovan Rosas, MD · Answer

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." 
Based on your photos, your implant choices do not seem unreasonable. I would not struggle over small differentials in volume (30 ml is less than a shot glass). You do have some asymmetry which will likely persist without a lift. It is crucial to remember that the implant will deliver fullness but it will not lift the breast.
Communication is key as you and your surgeon create your custom surgical plan. 
As always, discuss your concerns with a board certified plastic surgeon.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Choosing the right size and profile breast implants for you. 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. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I have been in practice for over 30 years and revisionary breast surgery is a large portion of my practice. I have performed surgery on thousands of cases similar to yours wanting to be smaller with more upper pole fullness. I have developed with a technique termed "reductive augmentation" which I published in 2017. It involves perform a breast augmentation, removal of inferior pole breast tissue,  and a mastopexy/lift. In your case, it is important to remove more tissue on the larger breast so you can use the same size and shape implant in both breasts. You should be able to have an excellent result. Best wishes to you

Vasileios Vasilakis, MD, FACS · Answer

Hello,
Thank you for the question. The size of the implants your surgeon suggested seems appropriate. A lot depends on the style (full vs. moderate) as well as brand of implants. You could go larger if this if you desired a more fullness. Also, on the right , a breast lift to improve symmetry should be considered.
I wish you the best. 
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Harry T. Haramis, MD, FACS · Answer

Breast augmentation can restore fullness without a lift, giving a more natural appearance.

Larger gel implants (300cc or so) placed half under muscle (dual plane) can help with mild drooping. Breasts will remain slightly low and more natural, consistent with your goals.

Further discussion with your/a plastic surgeon is recommended to address your concerns.

Darryl J. Blinski, MD · Answer

Based on your posted, photos, just doing an implant is an incorrect decision since it will not create improve the asymmetry and the sag of your breast and fill the upper portal list no matter what size your place unfortunately you need a full lift to correct a symmetry and then placement of a smaller implant in the 250 range or less in the dual plane as you previously stated to obtain the results your desire but downside is you will have the scars placed on your breast that you must address best of virtual console with for better understanding expect fees to arrange from $8000-$15,000.

Deciding if 300cc will achieve my outcome? (Photo)

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