What kind of results can I achieve with Breast Augmentation? Wide set, asymmetric, tubular shape breasts (Photo)

Question

I'm 25yo female. I It's hard for me to find before and after pics of Breast Augmentations that look like mine, so it's hard to understand what kind of results I can achieve. I've looked at over 500 pics and still can't find a before pic like mine. How wide will my gap be? Will they stick out to the side and go into my armpit? - They're wide set - Kinda tubular in shape - Asymmetrical - Major volume loss from weight loss - Also my sternum bone sticks My biggest worry is a wide cleavage gap

Wayne I. Yamahata, MD · Answer

There are anatomical limitations to the outcome from breast augmentation due to your natural anatomy. Seek a consultation with an experienced board-certified plastic surgeon who can provide realistic expectations for you.

Maryam Zamani (Saheb-Al-Zamani), MD · Answer

Hi @Polite681687,
Thank you for uploading your photos. While it's true that you have asymmetric breasts with tuberous characteristics and a wide prominent sternum, an individualized plan can help you achieve improved symmetry, increase in breast size, and less widened appearance of the sternum. I would advise seeking an experienced board-certified plastic surgeon as proper planning is key. Cohesive gel implants that are not too wide and placed in an exact pocket (I would recommend above muscle or subfascial) can help you achieve those goals without risking lateral malpositioning (the implants sitting too far to the side). If you have any areas from which fat can be taken, combining implants with fat transfer will help with a smoother, natural cleavage.

Gianfranco Frojo, MD · Answer

I would recommend finding a board-certified plastic surgeon who has preoperative 3D imaging capability. We can take your photo and simulate the surgery directly to eliminate the need to find any photos for comparison. Ideally, your surgeon also has completed an endorsed aesthetic felloship through the Aesthetic Society.

Daniel Barrett, MD · Answer

Dear Polite681687,
it is hard to tell for sure without an examination. Based on your photos, it looks like you would be a good candidate for BA. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

You have severe asymmetry of volume, shape and position. You also have widely separated breasts. You would benefit from a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Butz, MD · Answer

Thanks for your question. Everyone breast are different so it can be challenging to find one just like yours. 
You do not have tuberous breast deformity - mainly volume asymmetry and skin laxity from weightloss. 
I would likely use different sized implants to improve the volume asymmetry and a lift to improve the skin laxity difference. 
Your breast are set wide a part. Implants can certainly improve this but achieving braless cleavage is likely not realistic. 
You could use fat grafting to enhance the cleavage with the implants. Subfascial placement can also give us more control over the cleavage and not be limited by the muscle position. And lateral internal mesh bra support to minimal lateral shifting over time. 
Discuss your concerns with a board certified plastic surgeon and make sure their plan will achieve your goals. I think you could get a great result with your anatomy.

Zoran Potparic, MD · Answer

You are good candidate to improve current condition with proper breast augmentation. Small asymmetry needs to be discussed with a surgeon and options how to correct that. Distance, shape and position of  areola will not be changed significantly with augmentation and you will have to accept that fact. Overall you can expect quite an improvement. Good luck.

Brian K. Reedy, MD · Answer

Thanks for your question! If you look through my gallery or on my website, you should be able to find a couple that are similar to you. You will have a wider gap than someone who has naturally tighter cleavage. If that is a goal of yours, then you may want to consider fat grafting in conjunction to breast implants. Best of luck!

Ted Eisenberg, DO, FACOS, FAACS · Answer

Unfortunately, surgeons have created the term tuberous breasts, a fact which causes unnecessary concerns for women. Many women just have different sizes and shapes and in my opinion shouldn't be labeled. 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. 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. Mildly Sagging Breasts: If your breasts are mildly droopy, a saline or silicone gel implant placed behind the pectoral muscle might help create the illusion of perkiness. That’s because as the implant fills out the top of the breast, it also fills out the bottom, making it look as if the nipple has moved higher. It hasn’t. You can always get a lift later if you feel you are not perky enough when fully settled and healed. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. An examination in person by a board certified plastic surgeon is necessary to properly evaluate you and make specific treatment recommendations. That said, breast augmentation is one of the most common plastic surgery procedures but breast asymmetry needs to be carefully considered in planning and performing your surgery. From your photos alone it appears you would benefit from a subfascial breast augmentation most likely with different size implants to offset your asymmetry, with a possible need for a small lift of the lower breast to minimize the degree of asymmetry.

Do your research and select your plastic surgeon based on his or her Before and After gallery, reviews, your gut feeling about your connection with your surgeon, and your comfort level with the staff. More than one opinion may be necessary for you to feel confident. Be prepared with photos of your “favorites” or “wish photos” to review with your surgeon. Best of luck to you.