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

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.

Thank you for your inquiry! We, here at Mays Plastic Surgery, would like to sit down with you to discuss your concerns. Schedule a consultation with a Board-Certified Plastic Surgeon to help you reach your goals. After the consultation you are welcome to bring in some tops to try on to help with your decision.

Thank you for sharing your story so clearly. It’s completely understandable to feel unsure after getting different opinions, your goals are realistic, and it sounds like you know exactly the look you want to achieve.
Since you’ve had a breast reduction, your skin quality and existing breast shape will influence which implant will look and feel most natural. The right balance often comes from combining careful implant selection with subtle tissue reshaping to restore upper fullness without adding unnecessary size.
With a breast width diameter of 13.6 cm, a Moderate Plus implant in the 200–275 cc range typically provides natural, proportional fullness. A High Profile implant adds more projection and roundness but can sometimes appear too prominent after a reduction, while a Moderate Profile offers a softer slope with less upper volume.
If your main concern is the tissue beneath the nipple, your surgeon might also recommend a small skin-tightening adjustment at the same time, it can make a meaningful difference in lift and contour.
You don’t need a large implant to feel lifted and full again. With the right width, profile, and placement, you can absolutely achieve the natural, cupped-in look you’re describing.
Warm regards,Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon

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.

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

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.

Thanks for your question! I'm not seeing the photo where you are cupping your breasts, so it's hard to give you an exact answer. You can go to 5 more consults and get 5 more different opinions. Everyone has a reason for what they recommend. You should go with your gut and the approach that works best for you. Make sure to look at B&A photos of each surgeon you see to ensure you like the work you'd be getting. Good luck!

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size 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 is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Thank you for your question. They likely can be answered with aforementioned photos. Wish pics are helpful for your surgeon to work with you to attain the appearance you desire. With implants unfortunately, there is going to be some variability among surgeons in regard to size and projection. Continuing the dialogue with your surgeon will help allay your fears!

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.