I am scheduled to have a full mastopexy (bilateral) and subglandular augmentation with saline. Is 400cc good for me? (photo)

The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Although it is difficult to give you sizing advice on line, what I can say is that you will always be limited with implant size when you are having a lift done at the same time.  A breast lift will tighten the breast up as well as move the nipple and areola to a better and higher up location.  But the fact that the skin is being tightened up, it makes it difficult and unsafe to put in very large implants.Another advice would be to discuss why you are having implants placed in front of the muscle.  Given the loose and elastic nature of your skin (needing a lift), placing implants in front of the muscle will only cause the tissues to stretch faster over time.  In addition, you chances of capsular contracture are higher as well.  There are good techniques that help give a natural look, but still decrease your chances of capsular contracture as well has give upper pole coverage, to help prevent rippling in the future.Hope that helps.

Dear shauna71124,determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. 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 its 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, everyone of them have 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.Daniel Barrett, MD, MHA, MS  
Certified, American Board of Plastic Surgery 
Member, Am. Society of Plastic Surgery

A breast lift (mastopexy) is a great surgery for women with breasts similar to yours.  Adding a breast implant at the time of breast lift will help create more fullness in the breast.  The size of the implant is dependent upon many factors that I’m sure your board certified plastic surgeon took into consideration when helping you decide on the implant size.  It’s important for patients to feel they are “on the same page” with their surgeon. This may take another appointment to discuss realistic expectations and outcome with your surgeon.  I have women try on implants prior to surgery for them to get a better idea of what the additional volume will look like on their body taking into consideration their height, weight, shoulders, hips, etc.  This visual helps our patients feel comfortable with their choice.  Congratulations on your upcoming surgery.

It is absolutely impossible to determine by photos alone AND no other information what is best for you. A thorough consultation and physical examination are necessary to arrive at an appropriate size for you. You should see at least one or two (more?) reputable board certified plastic surgeons before making your decision.You would probably be happier and have a far better result if you use silicone implants and have them placed in a sub-muscular pocket.Steven Turkeltaub, MD

It's difficult to receive good advice based on only a single photo of yourself but I would recommend for a similar patient in my office a subpectoral silicone implant (cohesive) and a type of mastopexy determined by your size goals and physical anatomy.  This might be a full mastopexy, a vertical mastopexy or a J-mastopexy but would be determined best at the time of consultation.  400 ccs sounds somewhat large to me fyi.
Best wishes,
Jon A Perlman MD FACS 

Certified, Am Board of Plastic Surgery 

Member, Am. Society for Aesthetic Plastic Surgery (ASAPS) 

Member, Am. Society of Plastic Surgeons (ASPS)

Beverly Hills, Ca

The lift will limit the size of implant you can safely have. Choosing that size requires an examination. But with your body size and with a significant amount of natural tissue, adding 400cc will look extremely large.