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