Teardrop or round? (Photo)

Question

I was told that round implants did not suit me because of sagging. But too little sagging for a breast lift. They are also slightly asymmetric. What should be done here?

Jaime Caloca, Jr., MD · Answer

Without a doubt, a ROUND cohesive gel silicone implant is the best option. The reason is simple: The location on your breast where there is less volume is the UPPPER pole of the breast. THERE is where you need more volume. Therefore, an anatomical implant would be illogical since it has LESS volume on the upper pole. Besides, I have seen them rotate over time and that is why I do not use them myself. I consider that an implant is all you need, no traditional breast lift needed.

Jeffrey A. Sweat, MD · Answer

You do have some asymmetry of your breasts and it appears that your L breast is slightly more droopy (sagging) and than you R.  However, I don't see why you couldn't have round implants instead of tear drop.  The tear drop isn't really going to do much to lift the breasts any more than a round implant will.  You may need to get one or more opinions besides the one you have been given, then go with the surgeon who makes the most sense and gives you the best connection.  Best of luck!

Tania Medina de Garcia, MD · Answer

Hello
dear, thanks for your question and provided information as well..
The breasts may lose their elasticity and firmness which can be caused by
different factors such as pregnancy, massive weight loss, lactation and aging.
To reaffirm the breasts and restore the natural look your surgeon can perform a
mastopexy or breast lift. A breast lift
restores a firmer, perkier, and more aesthetically pleasing shape to sagging
breasts. This not only can improve a patient’s appearance by restoring her
youthful, feminine proportions, but  also help bras and swimsuits fit
more comfortably and attractively. By removing excess, stretched out skin,
reshaping the breast tissue, and raising the nipple & areola into a more
forward position, a cosmetic surgeon can create a more youthful breast
contour. Stretched, large areolae can also be reduced during breast
lift surgery, creating an overall better proportioned, natural looking breast, Actually
the perkiness on a person or another, depends on patients skin and breast
tissue, hugs!

Gary L. Ross, MBChB, FRCS · Answer

The question regarding round vs anatomical is only a small part of your decision making process. You have asymmetry and the left nipple is lower than the right and you will always have asymmetry afterwards. You need to be first sized in clinic and then following this one will need to decide on whether you would be happy with a lift and the scar patterns. You need to be shown examples of all the options which include augmentation only with round and anatomical, augmentation mastopexy with round/anatomical as a one and two stage procedure. You need to make an informed decision based on the pros and cons of each technique.You could have a round implant with a vertical lift. Aesthetically I do not feel that you will get a good result from a round implant on its own but if your priority is size and upper fullness and you choose to have a large round implant then it may be that you choose to go down the route of implant first and then as second stage have the lift. An anatomical implant will elevate the nipple height although on the left I doubt whether it will achieve everything you wish for. However saying that you need to be shown examples of what can be achieved by this approach so that you can make the decision as to whether this a result you would be happy with. You also need to consider whether to place different implants on each side and if you go for anatomical implants only the projection may need to be altered between the implants used on each side.This is not an easy decision making process and you may need more than one consult to make your own informed decision.

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery (based on the photographs, it is hard to tell whether you will also benefit from breast lifting; something you should discuss with your plastic surgeon).  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, and computer imaging) will be critical. Given that your surgery is coming up, I would suggest that you spend additional time communicating your goals/concerns directly with your plastic surgeon, preferably prior to the date of surgery.Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant type/size/profile/shape 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 "C cup or D cup” 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.

Shady Hayek, MD - Account Suspended · Answer

Dear Tina, In my experience,  using a round implant in your case should give an as good result as the tear drop shape if done well. My advise to you is to find a good surgeon with good results rather than depend on the shape of the implant.Best, Shady Hayek, M.D. Plastic and Reconstructive Surgery Beirut, Lebanon

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