4’11", 110 lbs, 31, breastfed 2 children. I want to get a lift with implants. Size, profile & placement suggestions? (Photos)

Hello, I am Dr. Özge Ergün. First of all, thank you for sharing your story and photos.
The clinical assessment indicates moderate ptosis and a significant volume deficit of the mammary mound. Consequently, I recommend a combined approach utilizing implant-based breast augmentation concurrent with a vertical scar mastopexy (breast lift).
A round, high-profile implant is deemed the most suitable option to achieve optimal projection and aesthetic contouring.
For the mastopexy component, precise implant placement is crucial for long-term stability and results. We recommend positioning the implant in the subglandular plane (above the muscle) rather than the submuscular plane. This technical decision is critical for mitigating the future risk of waterfall deformity, ensuring the stability of the breast tissue over the implant for a smooth, cohesive aesthetic outcome.

Dear Bright333476,

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

That’s a wonderful question, and you’re thinking about all the right details. Since you already have a 32C and mention severe sagging, the key to achieving larger, fuller breasts that sit beautifully without a bra will be not only the implant choice, but also the amount of lift and support created during surgery.
A high-profile implant gives more projection and fullness at the top, which can help restore that perky, rounded shape you want. However, when the skin has stretched significantly, high-profile implants alone can sometimes make the breast look heavy or unbalanced if the tissue isn’t lifted properly. In those cases, combining the augmentation with a breast lift provides the best, most long-lasting result, keeping the nipple centered and the breast beautifully supported.
A moderate-plus profile can also look gorgeous if you prefer a slightly softer, more natural slope. The difference between moderate-plus and high profile isn’t just projection, it’s how the implant’s width fits your chest. The right match will fill the breast perfectly without pushing it too far forward.
At 415cc, you’ll achieve a noticeable increase in size while still staying proportionate. Placing the implant under the muscle with a round, cohesive silicone implant typically creates the most natural, lifted look, it supports the tissue, smooths transitions, and helps your results age gracefully.
If your goal is full, round, and bra-free curves that still look elegant, you’ll likely need a lift with implants, not just for size, but for structure. When done precisely, the result can be soft, perky, and confidently beautiful without relying on a bra at all.
Dr. Sibel Atalay, MDBoard-Certified Plastic Surgeon & Destination Doctor

Thank you for your photos. To increase the size of your breasts, you would need a breast augmentation. Dimensional measurements of your breasts should be done to determine what implant size would fit best within the boundaries of your breasts. You are relatively petite so a 325 cc to 350 cc implant should give excellent size increase. Your skin is loose and has stretch marks indicating a loss of strength and elasticity and you have significant ptosis. To correct your ptosis you would require a breast lift. Adding additional weight to your breasts with an implant would place additional stretch on your skin, therefore, placement of an internal bra mesh to support the implant in its position would be prudent. As your breast tissue is very mobile, and you are likely to experience some settling of your breast tissue off the front of your implant, consideration should be made for resecting a wedge of tissue beneath your nipple/areola complex to help maintain the position of your breast relative to your implant over time. This procedure can be performed all at once. Another option is to perform your breast lift first and allow your tissues to mature and your breast to settle and then when you know that the position of your nipple is not going to change, undergo your breast augmentation at that point. This also allows you to refine the position of your lift should it have settled too much. Have a detailed consultation with your 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."
With regards to your specific question, a round submuscular augmentation is a very reasonable approach when paired with a lift. The choice of moderate vs. high profile will be question of desired upsize and breast width.
Communication is key as you and your surgeon create your custom surgical plan.
As always, discuss your concerns with a board certified plastic surgeon.

Round under the muscle. Choosing the right size and profile breast implants for you. I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. 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, if interested. 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

From the submitted photos you appear to be a good candidate for a breast lift with implants. Because of the skin laxity you may want to consider having the implants placed beneath the muscle for support. Another option is adding bioabsorbable mesh, especially if you are wanting a larger look. An exam and discussion of your goals are needed for a specific implant recommendation. I've included a video that I hope you find helpful.