145lbs goal, best implant placement and size to give cleavage and fullness? (Photos)

Unfortunately, with weight loss, breasts are commonly changed. Implants can help restore upper fullness, with size determined by your exam measurements and goals.

Larger implants placed half and half (dual plane) in my experience may avoid a lift while giving a more natural result.

Cleavage is dependent on your anatomy, the space or gap between breasts may be slightly improved, however when starting far apart, they will not touch in the middle without a bra.

Further exam and consultation with a plastic surgeon is recommended to discuss your options and expectations.

Improvement in cleavage has very little to do with whether the implant is above or below the muscle. The most important factor influencing the ability to create greater cleavage is what we call the "inter mammary distance", or gap between the breasts. As you correctly noted, your distance is fairly wide. Fullness in the inner portion of the breast can be improved with fat grafting at the time of implant placement as a composite breast augmentation. If you are concerned about bottoming out, you may also want to consider the addition of an absorbable mesh for additional support.

Dear resinrustics,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, 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 it is 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, every one of them has 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.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Dear resinrustics, Thank you for your question. After analyzing your case I can say you're a good candidate for Mommy Makeover (Vaser Liposuction + Tummy Tuck with Muscle repair + Ultrasound guided BBL and Breast augmentatiojnand Lift). I'm sure those procedures will give you an amazing result! Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

I have two great things to tell you about this, as it's a question many patients ask prior to breast augmentation. First, if you see a surgeon who has in-office imaging like me (Vectra, for example), you can "try on" different implants and see how they'll look on YOUR body. Second, check out goalfinder.bustmob.com , which is a site where patients submit their stats and photos. You can filter by height, weight, cup size, etc. Enjoy!

Your breasts are widely separated and you have no cleavage. I would recommend a breast lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. After this, I recommend a tummy tuck. If you are not planning future pregnancies, I recommend abdominoplasty with mesh reinforcement. The mesh creates a more hourglass figure by compressing the abdominal wall resulting in early satiety and helps maintain a reduced weight.

Best Wishes,

Gary Horndeski, M.D.

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Your question cannot be successfully answered in a forum like this or anywhere else on the internet. Selecting the proper implant for you requires using one of two validated systems: 3D simulation photography software or in office sizing, my preference. Both of these requires working with your surgeon in the office. Subfascial placement of implants has not been confirmed to be any different than over the muscle placement, thus putting you at higher risk of capsular contracture. Although subfascial or over the muscle placement helps improve the aesthetic of a sagging breast initially, the implant invariably drops into the capacious soft tissue envelope, well on it's way to a ball in sock appearance.

If you plan to loose weight it is very likely that 450 ml implant may be too large? Regarding the shape and clivage, it is not guaranteed based on the size of implant in many cases. However, fat grafting in the time of your secondary procedures (liposuction, TT) can significantly improve desired breast shape in experienced hands. Good luck.

If you are concerned about 450 cc's, then consider going down to about 400 cc's. For your build, I would suggest not going smaller than 350 cc's. I prefer behind the muscle for good coverage of the implant and more upper breast fullness.