The most important choices in achieving the best results for cosmetic breast surgery: the right surgeon, the right operation, and the right breast implants.Having been in private practice for over 20 years, a number of women have come to me because two or three years before they see me they underwent an augmentation with 600 or 700 cc breast implants and now they really don't like their breasts. The breasts are too large and too low and, even though they thought they would like how their breasts would look, they don't. I guess I differ from many plastic surgeons in how I talk with women who come in to learn about cosmetic breast surgery. We use 3-d imaging and I also have them stand in front of full length mirrors and I draw directly on their breasts to help them fully understand the options and the potential outcomes. Each choice has a different outcome. It is pretty predictable to me that women with larger breasts that are already droopy will not like their outcome a few years later if all they have done is placement of large breast implants. In my opinion, the outcome will be much better and last longer if a lift is performed along with placement of smaller rather than larger implants in these types of situations. That is not always the case, of course, but I find it to be true more often than not. There are situations where I will not operate on a woman because I think her expectations are not likely to be met. We still provide all of the information possible, but then I'll also tell her that I won't do what she is asking and I'll tell her why. We'll even provide names, addresses, and phone numbers of other good local plastic surgeons who do a lot of breast surgery and suggest she visit with them. In the majority of cases, I don't think it is a good idea to place 600 or 700 or 800 cc implants in a woman who already has larger, but droopy, breasts. In these situations I feel a little bit like a parent. My children sometimes are convinced that they want to have or do something. My responsibility as a parent isn't always to allow my children to have or do everything they want. My responsibility is to provide them with as much information as possible, to help them see things perhaps in ways that they hadn't considered, and to help them understand the pros and cons of things. Sometimes, despite all of this my children might still want to have or do something that's just not right and then I tell them, "No, because I said so". That happens from time to time here in the office; not often, but sometimes. So, yes, it's possible to get 630 cc high profile implants when you have larger breasts that are already droopy. And yes it is possible that you may be happy with the result. With only the pictures to go by, however, I would suggest an entirely different operation. But this is why the choices are so important: the right surgeon, the right operation, and the right breast implants. Visit with at least two other surgeons than the one you visited with, and don't just take the opinions offered here on RealSelf. Be open to what the surgeons say to you. Then make your decision.
