400cc sub muscular high profile implant - 34a to 34 ddd. Would a larger profile implant increase upper pole fullness? (Photos)

Question

1 year post op - Will it help my upper pole fullness to have a slightly larger higher profile implant replace what i have now. I do want to mention i do love them and how they turned out.

Guray Yesiladali, MD, FEBOPRAS · Answer

Hello. I reviewed your note and photos. At one year, the shape is stable so changes you make now are predictable.
What actually builds upper pole:• A higher projection implant can add fullness at rest. Best when the diameter still matches your base width• Pocket control is key. Tightening a loose lower pole or moving to a slightly higher dual plane can lift the device• Small volume fat grafting to the upper pole can refine the slope with minimal change elsewhereWill a larger higher profile help• A small step up can add a little fullness. The effect is modest and depends on strong pocket support• If the lower pole has relaxed a size change alone will not hold the upper pole
A practical revision path:• Confirm base width and choose an implant that matches it• Assess the pocket. Do capsulorrhaphy or an internal bra if the lower pole is loose• Add focused fat grafting to the upper pole when you want finesse rather than more projection
Smart questions for your consult:• Is my lower pole tight enough to hold upper volume• Do I need pocket tightening• Which diameter and profile match my frame while keeping a natural slope
Warm wishes for a smooth plan and a result you enjoy every day.Güray Yeşiladalı, MD

Vasileios Vasilakis, MD, FACS · Answer

Hello,
Thank you for the question. It depends on the stability of the lower pole, because a heavier implant might stretch the bottom aspect of your breasts. 
I wish you the best. 
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Gary M. Horndeski, MD · Answer

Your breasts are wider than your chest wall and a lot of the implant volume is going towards the axilla and around the curvature of the chest. Adding larger implants will make the situation worse. The only thing holding up the implants is the skin envelope, which is going to continue to stretch and descend. If you want more upper pole fullness, I recommend removing the implants, do inferior and lateral plication, extend the pockets higher up and place smaller implants high profile.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Shlomo Widder, MD · Answer

Dear Powerful,
    Thanks for posting your pictures. From observing your pictures you appear to be 34 full C or small D. Victoria secrets bras have always smaller cup size so you get a false bra cup size. To obtain a fuller upper pole with a natural slope , you will need to increase your implants by at least half size, which in your case is 75 cc or 475 cc implants. to get to 34 full D you will need 550 cc implants. Another important maneuver that will help to get a nice natural and fuller slope will be  superior capsulotomy (scar release) to enlarge the pocket and let the implants expand upward.
    Always consult with experience board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the photo gallery of redo breasts augmentation to make sure that they are numerous, consistent and attractive with nice cleavage, nice upper slope, nice projection and natural look.
                         Best of luck,
                                                Dr Widder
                                      widderplasticsurgery.com

George Marosan, MD · Answer

Thank you for your question and photos. Why would you like to change something that you love? Based on these photos, you do have a very nice result. What detracts from your result is the bilateral large axillary fat rolls which should've been addressed during your augmentation with liposuction. Your upper poles have a nice natural slope. If you were my patient, I would recommend fat grafting to the upper poles and cleavage and liposuction the axillary fat rolls. Would not recommend exchanging your implants. The more implant surgeries you have the more the risk for potential complications. Most surgeons will recommend implant exchange for obvious reasons, which might not be in your best interest. Good luck. Good luck.

Harry T. Haramis, MD, FACS · Answer

You would have to go up on volume, likely 600cc range, high profile. Can consider thicker gels for several cup sizes larger.

Another option is saline which will give more upper fullness with some trade offs.

Remember any revision has risks of capsule and other complications when considering your options and goals

Further discussion with your/a plastic surgeon to recommend.

Jacob Carlson, MD · Answer

Increasing the volume of the implant is one possible way to increase the amount of upper pole fullness that you have, but if you go about changing only the volume, you would have to increase the volume to get a wider implant to fill the upper pole. Just for the sake of example - to increase just 1cm in diameter from the 405cc High Profile Mentor BOOST implant, you have to go up to the 480cc implant. To go up 2cm in diameter, you would use the 635cc implant.
If you change the implant profile but keep the same volume, you can use a wider implant to fill the upper pole. The tradeoff in this scenario is that you lose some of the projection. So again, just for the sake of example - if you change the 405cc High Profile Mentor BOOST implant to the 400cc Moderate High Profile implant, you gain almost a centimeter in diameter but lose about half a centimeter in projection.
The third component to consider is the cohesivity. A more cohesive (firmer) implant is going to maintain the upper pole volume more than a less cohesive implant will. The different implant companies use different terminology to describe the cohesivity of the implants, but if maintaining upper pole fullness is your goal, I would recommend whatever the more cohesive gel that company makes
That was a long-winded way of saying that I would recommend changing a combination of the components of your implant to get more upper pole fullness. You have a fantastic result already, but if wanted to change them, I would recommend using a slightly larger implant with a lower profile and more cohesivity.

Darryl J. Blinski, MD · Answer

Based on nicely posted photos I would recommend virtual consultation. I also recommend change pocket to “dual” plane with 600-700cc high profile implants and use of inferior internal bra mesh. Fee $12,000+. Best to virtual consultation with .

400cc sub muscular high profile implant - 34a to 34 ddd. Would a larger profile implant increase upper pole fullness? (Photos)

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