It is very difficult to determine the best lift technique and the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a high profile cohesive 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link.
Yes, you can get HP implants with a lift and cohesive gel is a great choice. If you have a wide breast, then the moderate might fit better, but you can still do HP. Yes, if might give you a more fake look like your want, and we actually favor the HP for lift patients. Talk more with your surgeon. All the best, "Dr. Joe"
I recommend a new technique called Breast Augmentation with
Mini Ultimate Breast Lift™.Using only a
circumareola incision it is possible to reshape your breast tissue creating
upper pole fullness, elevate them higher on the chest wall and more medial to
increase your cleavage.Through the same
incision, implants can be placed.Aligning the areola, breast tissue and implant over the bony prominence
of the chest wall maximizes anterior projection with a minimal size
implant.Small round textured silicone
gel implants placed retro-pectoral look and feel more natural, are more stable,
less likely to ripple or have complications needing revision.Implant profile is irrelevant in the
retro-pectoral position since the muscle compresses it.You can achieve the high profile you desire by
alignment from the lift and implants, not by just large implants.
Gary Horndeski, M.D.
This question can only be answered after an exam and discussing your goals.
Kenneth Hughes, MD
Los Angeles, CA
Assuming that you do need a lift, you can certainly have the procedures done together. Unless you want to avoid the distortion that occurs with muscle contraction, the majority of surgeons, myself included, feel that submuscular placement is superior to over the muscle placement. As for the the profile, wide breasts require wider implants. If your chosen volume does not produce a wide enough base, you either need to use the lesser profile implant or go bigger in volume. If you don't meet eye to eye with your surgeon, get a second opinion as your surgeon should be doing everything possible to help you achieve the goals you have.
I would heed your plastic surgeon's recommendations. If you have a wide breast then you are probably not a candidate for a high-profile implant. I'm not aware that you need a lift because I don't have pictures and cannot perform a physical examine you. Again lean on your plastic surgeon's experience recommendations. Good luck
The profile chosen for you really depends upon what your breasts look like and your overall anatomy. Best to be seen in person. Good luck.
There are many advantages to having your breast implants placed beneath the chest muscle. Especially when a breast augmentation is done in combination with breast lift placing the implant under the muscle does protect the nipple areola from damage.
If you have a wide chest and wide breast moderate profile plus implants may be a better option. Implant size more than profile is important in creating the "fake look" that you want. If you are concerned you should consult a second plastic surgeon for an opinion.
For more information on combination of breast augmentation and breast lift please read the following link:
Beauty is in the eye of the beholder. If you like the fake round high profile look after breast augmentation, then that's fine. You are not alone. It doesn't matter about the lift. I agree with you that it should go under the muscle. Your surgeon is concerned that with widely separated breasts, the high profile implant will be narrower than a moderate profile implant of the same volume. The wider moderate profile implant will do a better job of making your breast look less wide apart than the high profile implant, especially if the wider moderate profile implant is placed on top of the muscle rather than underneath the muscle. But here again, I think the implant is best placed under the muscle especially when you are doing a lift, and the implant in my opinion has to be textured.
If you have seen an ABPS-certified plastic surgeon who is also a member of ASAPS and experienced in breast surgery, it seems foolish to think your training and experience in plastic surgery of the breast is somehow better than any plastic surgeon you may consult with. (I know, it's your body and your money. But that doesn't mean you should decide what is best procedure-wise.)
An informed patient who has done her research is great, but not if she thinks she knows better than 4 years of medical school, 6-8 or more years of post-MD surgical training and plastic surgical training, and whatever years of surgical practice and hundreds or thousands of patients have taught the surgeon. So asking questions is great, and I applaud you for doing that here. But not if you're simply seeking validation of your own ideas. You gotta listen to the answers!
A lift cannot be done with implants above the muscle (since that is the tissue layer where the lift is performed), so your surgeon is suggesting that above the muscle implants might be preferable to a lift, not in addition to a lift. But without photos or physical examination and careful measurements, it is impossible for any online consultant to give meaningful advice.
To really figure out what might be best for your goals and anatomy, I'd suggest one or two more in-person consultations with ABPS-certified plastic surgeons (ASAPS members) with lots of breast surgery experience. State your goals, not your proposed solution, and listen to the suggested ways to best achieve your goals. If your goals are unreasonable, your consultants should tell you what part is unreasonable, and what parts are not. Now you can make an informed decision about whom to trust with your body and $$$.
BTW, "fake" is a look that a few women really prefer (nothing wrong with that), BUT, what they don't understand is that the high, tight, "Baywatch coconut" look they find so attractive is also accompanied by feeling like a couple of croquet balls in your vest pockets! Capsular contracture is what causes this look in many women with poorly-performed breast implants, and above the muscle has a higher risk of this occurring. Below the muscle is not only required for a lift plus implants, but submuscular implants have a much lower risk of developing capsular contracture. Rarely do I recommend above the muscle these days. Just saying.
Best wishes! Dr. Tholen