Based on my pictures, what do I tell my plastic surgeon to achieve the results I want from my breast augmentation?

Question

25 years old / 160 lbs / 5'6" / Size Before Surgery: 38A / Size I Want: Full D / Surgery Date: November 22, 2013 / Saline Implants: Natrelle STYLE 68MP MODERATE PROFILE, 420cc each filled to 475cc / Under the muscle / Inframammary Crease. What do you think? I am not happy with how they look. They are wide apart and there is no upper pole fullness. I still feel flat chested, even more when I lay down. I want more fullness at the top of my breasts.

Charles Cope, MD · Answer

Hi. You have clearly described what you want, so your surgeon should be able to discuss things with you. If you want more upper pole fullness then changing the profile of the implant to a higher one and increasing the size will achieve this. There are tradeoffs however, in terms of more long-term problems with larger implants such as rippling. Best of luck with your decision. Regards Dr Charles Cope

Robert Frank, MD · Answer

First of all, I think you have a very nice result. Your cleavage is very natural and while it may not be exactly what you saw on the pics you posted, you shouldn't feel strange or dissatisfied by your result. So with that said, a couple thoughts. First, you have a wide chest. At 5'6' the fact that you're in a 38" bra likely means your chest (and by that I mean ribs and sternum) are larger than those of the patient you posted. Your breasts will likely sit further apart and your cleavage wont be as tight as hers. Just the way you're built. You could go for a larger implant which would give you more upper pole fullness and would make you feel less flat chested. I'm not sure it would be worth doing unless you were increasing 100-150 cc which is a big step up and would make palpability and rippling more of a potential problem. Going to that implant size might put you in a high profile implant but, without your base diameter measurements that would be for your surgeon to decide. Good luck.

Darryl J. Blinski, MD · Answer

You need a larger sized implant in the 600 cc range to achieve the fullness look. As for wide set appearance is part your chest wall anatomy anne part too large a lateral pocket. Best too discuss with your surgeon.../

Tom J. Pousti, MD · Answer

I would suggest that you communicate with your plastic surgeon in a similar fashion that you have communicated here. In other words, both verbal and photographic (goal pictures) communication will be helpful.   Show him/her what you are trying to achieve while standing in front of a full-length mirror and/or while lying down.It may be that the use of larger volume implant and/or internal suture “adjustments” of the breast implant pockets (capsulorraphy)  will be helpful/necessary to keep the breast implants where you wish them to be both in the upright and supine positions.  Make sure that your plastic surgeon does have significant experience with revisionary breast surgery. I hope this, and the attached link, helps.

Douglas J. Mackenzie, MD · Answer

I agree with everything Dr. Frank said so I am not going to repeat his comments.  But to expand on one point, you must realize that the most important thing predicting how you will look afterward is how you look BEFORE surgery.  After all, with a straight breast augmentation, we are creating a pocket and slipping an implant into it.  Sure, there are many different sizes, styles, and shapes of implants, but there is not much we can actually do to change the breast itself (this is in contrast to breast lifts or reductions, where we DO change the breast), or for that matter your ribcage or where your pec muscle inserts, etc. Your pre-operative breast shape is significantly different from the woman in the photo you liked.  I think you actually have a nice result.

Based on my pictures, what do I tell my plastic surgeon to achieve the results I want from my breast augmentation?

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