What is a Large Volume, but Low Projection Breast Implant Going to Do for Me? (photo)

In choosing implant size, the base width diameter is important. Patients do not want a large gap between the breasts and do want breast width proportional to their body size. In general it looks nice to have an implant width within a centimeter of your base width diameter (width of your natural breast footprint). Once you find the right diameter of implant, you can use different types of projection of implant (low, mid, high) to adjust the overall size of the breast and the appearance from the side view. Higher projection implants are generally a bra cup size larger for the same width of implant. Higher projection implants make your nipple look further out from your chest from the side view. In my office, I use a 3-D image machine to see approximately how the different implant styles look in each patient. Then you can try them on in a bra to see what bra size they fill. In your case, find an implant size that is wide enough and is a bra size with which you are comfortable. Also remember extremely large sizes sag more with time.

In your photographs you appear to be leaning backwards.  If you stood straight your breasts would actually be lower than they appear in the photographs.  You would benefit from a breast lift at the time of implant.  The breast lift can be done through a circumareola incision and lift your breast tissue higher, give you more upper pole fullness and increase your cleavage.  An implant can be placed using this incision.  I recommend silicone gel implants placed retro-pectoral since it is more stable long term and looks and feel more natural.  The profile of the implant does not matter when placed under the muscle since the muscle compresses the implant.  If you are large you can handle a larger size implant.  However, if the implant is too large it will descend inferiorly and laterally and you will need revisions (450 cc implants weigh approximately 1 lb).  Maximum projection is achieved by aligning your breast with the bony prominence of your chest.  Combining a lift with implant will allow the use of a smaller implant.  You are a perfect candidate for a technique called Breast Augmentation with Mini Ultimate Breast Lift.

Best Wishes,

Gary Horndeski, M.D.

Thanks for the question and posting the photos. I might suggest you attempt some weight loss prior to having any surgery. But if I had to chose I would opt for moderate profile plus implants in 450 to 550 cc range. Best to you.