39 yo, 5', 149lbs, 36C - (photos)

Question

I am getting my surgery done on August 3rd 2016 and would like to know if this is the right fit for me. My doctor suggests 550cc (minimum and max of 650cc) Moderate Plus Profile Silicone although I was thinking of going 650cc High Profile. The dimension of my width is about 15cm. I do realize that the implants can still drop over time. Based on my photo below, do you think my doctor is correct with his assessment? I do still have time to change things out if you have any suggestions. Thanks.

Shlomo Widder, MD · Answer

Dear MsBehave,      Thanks for submitting your picture.     From observing your picture, you appear to be asymmetrical B cup size with level 2 ptosis and large areolas.  Based on the above assessment, I would strongly recommend at least mini lift (donut )procedure with the breasts augmentation. Without it, either your ptosis will worsen or if your surgeon will try to lower the crease significantly in order to elevate the nipples, it is highly likely that you will develop double bubble complication. Additionally, you areolas will become even larger due to the stretching by the implants.   As far as implants size selection, since you are presently 36 B cup size,  550 cc implants will bring to to 36 DD. 650 cc - 36 full DD. Is that what you had in mind ?  My most popular size is full C or small D cup size, which in your case will be 350 cc - 400 cc.   Always consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly , check the before and after pictures in the photo gallery, to make sure that the are numerous, consistent and attractive with nice cleavage, perky, symmetrical and natural looking.                      Best of luck,                                           D r Widder

Joseph G. Bauer, MD, FACS · Answer

It's difficult to make an assessment based on the photograph alone, especially with your arms elevated. If you have any concerns about the appropriate implant size, I would recommend you revisit with your board certified  plastic surgeon prior to surgery. Thank you for your question and for your photograph. Best of luck.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.    If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.

Silicone will give you a fullness at the top (upper pole fullness).

Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.

These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

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 and restorative breast surgery.

best of luck!

Dr Schwartz

Board Certified Plastic Surgeon

Director-Beverly Hills Breast and Body Institute

#RealSelf100Surgeon

Steven M. Camp, MD · Answer

Thanks for your question and picture.  I would recommend another appointment with your surgeon to better discuss your implant choice. If possible, see if your surgeon has access to a 3D imaging device to help show your before and after photos for your specific body.Wishing you all the best,Steven Camp MD#HappyCamperMD

Tom J. Pousti, MD · Answer

Thank you for the question and picture; it is difficult for me to know, especially with your arms elevated, whether or not you will benefit breast lifting surgery as well.   If there is any doubt, discuss this with your plastic surgeon.  Given your concerns regarding breast implant size, I would suggest that you spend more time with him/her anyway, preferably prior to the date of surgery. Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging)  as well as careful measurements (dimensional planning) will be critical.

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation 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. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining 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. For example, I have found that the use of know words such as “natural” or "D or DD cup” or "right fit for me" etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

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, after the use of temporary intraoperative sizers.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Jon A. Perlman, MD (retired) · Answer

Thank you for your photos.  Though face-to-face examination is necessary to give you good advice I would say that generally speaking patients whom I see with your shape are felt to be a candidate for an uplift combined with placement of more moderate sized breast implants.  Think carefully about the change in your areolar diameter and position with placement of large breast implants of the size range you suggest.  I would be considering either a Benelli periareolar uplift or possibly a full uplift in conjunction with placement of moderate sized implants.Please remember that this may not be the best advice for you since I am uncertain as to what your goals are and your tolerance for surgical incisions might be.  I do think however that this might give someone with your size and shape a better aesthetic result.Make sure that you are comfortable with your choices before proceeding and if uncertain plan to meet as many times necessary with your ABPS board-certified plastic surgeon to review your options.  Best wishes and good luck.Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)Beverly Hills, California

39 yo, 5', 149lbs, 36C - (photos)

Answers (6)