450cc too big for me? Breast lift with silicone implants (Photo)

A small implant with a breast lift would produce a nice result to meet your goals. You could opt for the breast lift and have breast fat transfer a few months later.  Try on a profile bra with various silicone moderate cc sizers (400-450cc) under a tailored blouse, tight sweater, swimsuit, workout clothes, and other garments you typically wear so that you have the best idea of whether the garments fit as desired with the implant selected. Adjust the cc's until you can convey to your PS the natural-looking results you are seeking.  Based upon his/her credentials, trust your board certified plastic surgeon to make the best decision in the OR when the implants are placed.  

Hello,Thank you for your question. An in-person consultation could provide the best options for you. You may benefit from the Breast Augmentation procedures combined with achor type lifting. The ideal size can be set only during in person examination taking into consideration your chest wall, weight and body proportions. The decision of the implant's place made depending on your breast tissue. I personally prefer inframammarial approach, which is also the most common technique in the world, as this allows the most beautiful shape of breasts on one hand and minimizes potential complications in the post-operative process on the other hand. 
An experienced Board certified plastic surgeon could evaluate your case properly. To find out more please click on the attached link. 

Best Regards

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  Based on your photographs, the best shape and contour could be achieved with a smaller implant and a breast lift. The size, profile, and shape of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.Best wishes and good luck.


Richard G. Reish, M.D.  FACS

Harvard-trained plastic surgeon
 

If you are currently a 32 DDD and do not want to be a DDD, why are you getting implants?  There is common misperception that implants are required for upper pole fullness.  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 and the ability to breast feed are maintained.  Implants are not lifetime devices.  450 cc implants weigh 1 lb each and will result in descent of your breasts again.  You should not undergo implantation if you already have DDD breasts.Best Wishes,Gary Horndeski, M.D.

Dear djmpo24,
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

I would suggest going down to a full C to small D so that your lift will last longer. Stretched out sagging tissue will not support heavy weight long.

Number one you are very asymmetric and do have a good amount of breast tissue.  I feel that you will stretch a lot with a lift and almost any implnat. I feel that it is a dangerous operation to remove breast tissue and add an implant.  You could have tissue necrosis  and nipple loss. It may be more beneficial to do a reduction and lift at one time followed by an augmentation at least 6 months later.

Thank you for the question.   
It is definitely worth spending more time (prior to the date of surgery) with your plastic surgeon to discuss further.  As you know, it will be important for many reasons, that you feel comfortable that you and your plastic surgeon are on the "same page" prior to proceeding.  Show your plastic surgeon what you mean by your goal of "DD cup"  using as many visual aids as possible.   As you can imagine, these terms can be interpreted differently by different people. This additional communication will go a  long way when it comes to helping alleviate your anxiety prior to proceeding.
 Some general thoughts regarding this combination procedure may be helpful to you:
 Generally speaking, patients undergoing the breast augmentation/lifting combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery. 
Also, patients undergoing the combination breast augmentation/lifting surgery should understand that there are limits as to how large of an outcome can be achieved, given that breast lifting surgery does involve breast skin removal. On the one hand, breast augmentation surgery is expanding the breast skin “envelope” while breast lifting is (by definition) tightening up the breast skin envelope. These 2 forces are counteracting each other. 
Therefore, it becomes important to remove the appropriate amount of breast skin and to use the appropriate size/profile of breast implants to balance these 2 forces appropriately and to allow for achievement of the patient's goals while minimizing risks of complications. 
In my practice, "tailor tacking" is an important part of the mastopexy and mastopexy/augmentation procedure. It involves TEMPORARY  closure of the skin (for example with temporary skin staples)  to double check the amount of skin that is to be excised during the procedure. This maneuver is done to ensure that enough skin, but not too much, is removed. On the one hand, it is important that enough skin be removed to achieve the aesthetic breast lifting results the patient is looking for; on the other hand, is important not to move too much skin creating tension upon closure and potential wide scars.
 
Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting surgery (regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. 
2. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural or larger breasts” or "DD or DDD cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.
Best wishes.

Restoring shape and volume is what breast enhancement procedures are all about.  When there is loose skin, this must be addressed.  There are many options available with different lift procedures and a multitude of breast implant options.  Here is a basic list of the four options available:
Breast lift alone (mastopexy)Breast lift combined with a small breast implant (below the muscle)Breast lift followed by a large breast implant (2 separate procedures)Breast implant alone (on top of the muscle, silicone)Every woman is built differently and every breast is different, even on the same person.  So, each procedure is customized for every individual.  The final decision on how to proceed can be made after a history and physical examination, detailed measurements, photographs, computer simulation, trying on sizers, reviewing before and after photographs of other women similar in shape and size and talking with your surgeon.  A surgical plan will be developed that depends on:
Patient desiresThe breast "footprint"The expertise of the surgeonCostDown timeScarsRisks and potential complicationsPlease consult with a Board Certified Plastic Surgeon who performs breast enhancement procedures frequently.  This is an outpatient procedure with a quick recovery and a very high patient satisfaction rating.  Based on the photographs submitted I would recommend a staged procedure; an asymmetrical breast lift/reduction followed in 6-8 weeks by a breast augmentation with implants under the muscle.
Good Luck!