Need Advice: Wide Chest, Sagging Tissue, Want Fullness Without Huge Size. What size and profile should I choose? (Photos)

Question

I’m looking for a little guidance on how to reach my goal. I’m 5’3”, 145lbs, 36C, and had a breast reduction back in 2021. After some weight fluctuations, this is where things stand today. I really want to remove the sagging tissue under my nipples and add an implant to get that upper pole fullness. The way I’m cupping my breasts in the photo is exactly the look I’m going for. I’ve had a few consultations, but everyone’s telling me something different and I’m feeling a little lost: • Consult #1: Sientra High Profile 225cc • Consult #2: Moderate Plus 150cc (feels too small since my BWD is 13.6) • Consult #3: (pics attached) Mentor Moderate Profile 345cc or High Profile 335cc — I like the roundness of the HP but they look too big for me.

Camille Cash, MD · Answer

The issue with opinions is that you'll get many and they may not all match.  It's difficult to give you a firm recommendation without talking to you and examining you.  You've been on a few consultations.  I encourage you to review the advice given and go with the one that you feel best matches the look you are wanting.  I don't think there's a perfect answer, but your gut will tell you which is the one that is closest to your goal look.

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." Communication is key as you and your surgeon create your custom surgical plan. 
With regards to your particular question, all if the proposed options while different are reasonable. You can go to 10 more consults and get 10 more answers. It is up to you to best define your goals and what you hope to achieve. Once defined, stay close to your measurements.
As always, discuss your concerns with a board certified plastic surgeon.

Wayne I. Yamahata, MD · Answer

It is not possible to give an accurate recommendation for implant volume based upon your limited information and photos alone. One consideration when selecting your implant is that if you want to limit your volume enhancement, you may need to go to a lower profile to have an adequate base width.

Daniel Barrett, MD · Answer

Dear aliciajoybs,

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

Zoran Potparic, MD · Answer

There are several ways to help your search to achieve desired look and size. You have obviously gone through that process and learned something. This is entirely your decision. It is “the most difficult decision to make” but most patients, in our experience, are happy with selection they make based on their own instincts. Good luck.

Need Advice: Wide Chest, Sagging Tissue, Want Fullness Without Huge Size. What size and profile should I choose? (Photos)

Answers (9)

Answer: Implant size

Answer: Implant size

Answer: Decision about volume of breast implants

Answer: Decision about volume of breast implants

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Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.

Need Advice: Wide Chest, Sagging Tissue, Want Fullness Without Huge Size. What size and profile should I choose? (Photos)

Answers (9)

Answer: Implant size

Answer: Implant size

Answer: Decision about volume of breast implants

Answer: Decision about volume of breast implants

Browse related questions

Recommended reading

Everything you need to know about Breast Augmentation

Our mission is to create a world where every investment in modern beauty is Worth It.