Breast Lift & silicone implants - Is 350cc too big? (photo)

Hi B!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. 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". 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 oz. (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. Then, the patient’s verbal requests
are factored into the analysis.Our
average size over the last 7,000 implants was 350. 90% of our patients wish they were bigger a year after BA.I t is like
your mind incorporates the "new you" into it's self-image over a
period of time. 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 (Flash) Recovery Breast
Augmentation articles from peer-reviewed surgery journals.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”

Thanks for the photos, but I would also want to know your height, weight, nipple-to-clavicle, and nipple-to-crease positions. If you are not at all concerned about the size or shape of your areolas, and really do not "need" a lift, you may wish to consider augmentation alone. A periareolar "lift" really does not lift very much at all, tends to flatten out the breasts, and can often yield irregular, wide, or "pleated" scars that don't always heal as nicely as the example photos you tend to see. I used to do a lot of them early in my career, but have largely abandoned them for better options in most cases. Your goal photo shows a nice result and minimal scarring, but they don't all turn out that way! And you can't "take it back," but you CAN add it later. Just a consideration. Read the section in my Comprehensive Guide to Breast Augmentation on incision choices, as a periareolar "lift" will involve going through breast tissue and ductal bacteria, potentially increasing risk of capsular contracture.340cc and 350cc implants differ by 2 teaspoons, and should be considered visibly equivalent in your body. They will add between 1 1/2 or nearly two bra cup sizes to your present size. Try on 300cc implants in a stretchy bra or top in your plastic surgeon's office and see if you like this look. Using 350cc implants will then accommodate for the submuscular compression that occurs with beneath-the-muscle placement. If you like the look of 350cc implants in a stretchy top, your surgeon may want to use around 400cc implants. With your concern about being "too large," then perhaps 350cc is exactly what you want.Goal photographs are always a good idea, as is online research with websites that show lots of before and afters and list implant sizes. At least this helps give you an idea that 350cc implants are not "huge" nor will they make most women look "fat" or "top-heavy." Keep on doing research and try on implants. Best wishes for a splendid outcome! Dr. Tholen

Thank you for the question and pictures. Based on your photographs, you should have a very nice outcome with breast augmentation/lifting surgery. Unfortunately, in regards to specific size/profile of breast implant, despite good intentions, online consultants will not be able to provide you with meaningful specific advice. Ultimately, you will do well spending additional time with your plastic surgeon communicating your goals, questions, and concerns. Do not proceed to the operating room until you feel comfortable that you are both on the same page when it comes to the goals you are trying to achieve. In other words, careful measurements, dimensional planning, and careful communication will be key. Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery.
Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup" or "too big" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. The use of computer imaging may be very helpful during this communication phase.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy.
I hope this, and the attached link, helps.