Implants large vs small - how do I know? I want 44DD. (Photos)

Question

I lost a lot of weight and my amazing doctor will be performing a lift for me Jan 9. He doesn’t want to add implants for me because he says my skin won’t support them. He said I can do a small one later if I am persistent. He doesn’t care much for bigger breast from what I gather but I want 44DD. I have the gummy bears being donated to me. What can I do to strengthen my skin to support larger and is it just is opinion because I see women with big boobs that look great!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  Congratulations on your weight loss.  The
best advice you can receive is from an in-person consultation.  Since your surgeon will be performing a breast lift as a first stage procedure, it would be advisable to wait until after the breast lift and then decide 6 months later what size implant you may want.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.  FACS
Harvard-trained plastic surgeon

Itzhak Nir, MD, FACS · Answer

The best thing you can do is to heal from the Lift that you will be having. You have very droopy breasts and a lot of skin and tissue will need to be removed to get them into the correct position. The most important thing you can do is to heal from the initial surgery. After 6 months or so, you can have implants placed. I hope this has helped

Jon Kurkjian, MD · Answer

Thank you for your question and photos
There are several variables to be considered when answering this question. It is always difficult to make a diagnosis based on photos alone, however, you do appear to be a good candidate for a breast augmentation with a lift. When you meet with a board certified plastic surgeon, they will perform a set of measurements that will help determine whether or not a lift is necessary and what approach they will take. This will determine the type of incisions you will have. Another variable that needs to be discussed is what you are wanting. If you are wanting a fuller upper pole to your breast, then an implant will be necessary.  If you are just wanting the breasts to be a little perkier and don't mind the size, then only a lift is necessary. And to have the nipple in proper position over the implant, may require a lift. I hope this is helpful

Robert Oliver Jr., MD · Answer

Im going to disagree with the idea you need to stage this. We do this all the time, and I personally would rather do this in a single stage and accept possibly needing to revise the lift rather then committing you to big 2 operations up front and still having a high revision rate. I would be careful in promising a specific cup size result, but say that a D to DD range is achievable.

Thomas Hubbard, MD, FACS · Answer

Great job with the weight loss!  With the severe sag that you have it is very reasonable to get the best lift you can first and then have implants later.  Size and skin support is a matter of opinion.  In my opinion implants placed under the muscle are very well supported without the skin.  You can have your larger implants placed later in my opinion.

Ege Ozgentas, MD · Answer

Dear LifeChanger123,
What you need is a breast reduction and lifting at the same time. You have enough tissue in your breasts and after a small amount of reduction with areola lifting with breast tissue your breasts look more projected and bigger than before. For me you do not need and extra silicone breast augmentation. However it (silicon augmentation) can be done at the same time if you want it.
Good luck.
Ege Ozgentas
Istanbul Turkey

Brooke R. Seckel, MD, FACS (retired) · Answer

Congratulations on your weight loss.  Your surgeon is giving you good advice.  I would urge her to have your breast lift first and wait until your breasts have assumed her final shape someplace between 6 months and 1 year.  If he's still want implants at that point your surgeon can use a sling created by Acellular dermal matrix to help hold your implant into place and avoid sagging again.

Implants large vs small - how do I know? I want 44DD. (Photos)

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