Breast Augmentation and Mastopexy. Is 400cc right for me? Small deflated C after breastfeeding! Would like a full D/DD. (photo)

Thanks for your photo. As you have enough breast tissue my advise to you would be an implant size of 330/400 cc with mastopexia and lollipop scar for achieving a D cup. Please consult with a board certified plastic surgeon and good luck...

A mastopexy or breast lift operation is designed to improve the shape and position of the breast without reducing their size. It is used for breasts which sag or droop (ptosis). Sagging of the breasts may occur with normal development for some women, or as part of the aging process. Pregnancy, breast-feeding and weight loss are other conditions which increase breast ptosis. Some patients will have a better shape to their breast such as increased superior fullness if an implant is used at the time of mastopexy. The procedure can also be combined with a minor breast reduction to reduce the breast width if desired. The surgery will create an elevated, more youthful breast contour. Also, the procedure will create nipple and areolae of the desired size and at the correct height.



I prefer to  use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.Now, in order to help determine what the best implant size for your desired result should be it would be best to seek out a local board certified plastic surgeon for a live consultation to receive advice based on your individual situation. The necessary size of implants can be different for every patient, so a certified surgeon would be best to determine for you. Good luck!

Your breasts look heavy and are sagging somewhat so it's very important not to use an implant this is too large since that will compromise your breast lift. The women you show as "ideal" likely did not have a breast lift so it's difficult to compare yourself to them. I would go with a more conservative breast implant size (

thank you for your question. In my practice I use the Vectra 3-D imaging system to simulate breast augmentations  plus or minus a lift and to asses different sizes in your breast.  I highly recommend you see a board-certified plastic surgeon who has this type of technology in order for you to pick the perfect size and have the ideal results.

Hi LuLu!  I think you may be on the right track with the 400.  (I haven't examined you.  Please put an index
card in your breast fold.  If your nipple is at the edge of the card or
below, then you would be a candidate for a lift, either a vertical or anchor or
areolar incision.  If your nipple is above the edge, you could be a
candidate for an internal lift called the dual plane.  Here are a few tips for you because this is perhaps
the hardest decision for a patient to make, as well as the surgeon.  Also see the video attached to my answer.  We spend up to two hours for our BA consults
to be sure there is careful communication. We do a full exam in front of a
full-length mirror taking six exact measurements.    We
put your photos on a large computer screen for imaging, and go over your
“ideal-size” photos. We then save this information to your password protected
“web account.”


   First and
foremost the implant should fit the dimensions of your breast and tissue cover.
 Balancing the implant to your
over-all body shape and tissue cover is essential.    The main thing is to
have the diameter of the implant fit the diameter of your breast "foot-print".
 Higher profile implants tend to have a smaller diameter.  Higher is really a marketing term, but often
translates into the same volume implant with a narrower base.  Saline implants actually tend to decrease in
diameter as they are inflated!  The average size chosen over our last 7,000 breast implants was
“350cc”.  BUT, 90% of our patients tell us they wish they were
bigger a year after BA.  (We will see you
every year for routine checks at no charge.) It’s like your mind incorporates
the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
 You can try on implants in the office by
placing them into a special bra.  The implant is also flattened somewhat when under
the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket.  Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues.  Multiple measurements need to
be taken to fit an implant to your exact anatomy.  Have your surgeon's
office show you the charts of the implant dimensions for the various profiles
of silicone and saline from the manufacturer.  Then you and your surgeon
can piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan.  Keep in mind
larger implants tend to have more problems over the years.  Since silicone implants wrinkle less than
saline implants, they might be your best bet.

     You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra.  Wear this around the house for a while, and
see what you think.  Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
 Multiple measurements of your chest wall
are taken (seven in total).  Implant size
selection has been an issue of much discussion.

    
Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.  Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape.  A photo album of patient
pictures is maintained to assist them.  These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery.  In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover.  Finally,
your verbal requests are factored into the analysis.

     We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals.  It is a surgical procedure that
uses special instruments and techniques to minimize tissue damage and avoid
touching the ribs. It causes far less trauma to surrounding tissue than
traditional approaches, and it dramatically reduces pain and recovery time. In
published studies of BA patients, 95-percent of women interviewed after the
procedure returned to normal daily activities within 24-hours. Quick-recovery
BA is not a “gimmick.”  These specialized
techniques, which actually speed recovery and get you back to your daily
routine, kids and work, are published in our plastic surgery journals.  Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype. 

     Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons).  Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year.  Be sure the PS has been in practice for a
while, about 20-years might be a good gauge. 
Does the PS offer all three incisions? 
Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach." 
Ask to see their before and after photos if you didn’t see any on their
website.  If they are experienced, they should have several 100 breast
implant patients for you to view.  I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you.  You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center.  Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.      All the best, “Dr. Joe”





 





 

Based on the above information, 400 cc should be close to achieving your goals.  Your surgeon will have a better opportunity to fine tune the best breast implants for your goals.Best Wishes,Nana Mizuguchi, MD

Tissue based planning is always best when trying to determine proper size. Showing your surgeon pictures of your desired "look" will help them decide on the profile. You will most likely want a Mod+ not a Mod. Difference between 350 and 400cc isn't a lot, and you likely won't see or feel a real difference. going from a deflated C and adding 350-400cc you will increase your breast size(assuming same bra manufacture) approx 2 cup sizes if the implant is placed under the muscle. Your surgeon likely has some way to help size you in his/her office and this may ultimately help you determine how big you want to go, assuming your chest dimensions will allow these implants without causing problems for you. Best of luck. 

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Hi and thanks for the question. Without examining you primarily and taking chest measurements, its difficult to give you accurate advice in regards to the implant size. In general, following the physical exam, I discuss what the patients perceived ideal goals are. From there, we generate a course of action, assuming her goals are reasonable and in her best interest. The final implant size is difinitively chosen in the OR during the case, as this allows us the greatest degree of accuracy in selecting an implant that will produce an optimal breast silhouette with the augmentation-mastopexy.Best wishes,Dr. Vallecillos 

I agree with your focus on the details. From the pictures you selected it is clear that upper breast fullness is important to you.  I think that this is a critical aspect of the procedure- to create a well defined cleavage and what I clinically refer to as "upper breast pole fullness".With regards to the volumes you mentioned, I would recommend the larger, the difference is between 100 to 50 cc depending if you go with 300 cc or 350cc implants.I hope this helpsSergio P. Maggi, MD, FACSAustin Plastic Surgery Centerdrmaggi.com