150-200cc. Does this profile and size make sense? (photo)

Selecting the best implant for a patient is a very complex process and is even more challenging when combining this with a lift. Although surgeons can provide an opinion based on the photographs and numbers you've provided, the best answer should come from your surgeon. He or she would have had the opportunity to exam you in person and can gleam additional information that would aid implant selection. If you've done your research in selecting your surgeon, then you should trust your surgeon to select the best implant for you.

The anchor lift leaves excessive scarring, a boxy shape, and is not a very effective lift. A vertical lift plus implants is your best option for the best lift and least amount of scarring, plus a more conical breast shape. I would recommend under the muscle. You should consider an implant volume of 300 cc and a high profile, judging from the photos you attached.

Based on your photos, I'll give my opinion that you certainly cannot get close to your desired goals based on a single surgery. The breast is 'deflated' and there is a lot of loose skin, with the nipple quite low. You are thin and your muscles are strong, so the idea would be to give you a nice shape as well as fullness. This is difficult to do in a single surgery and time and again we have seen success when the 'lift part' and the 'augment part' are separated. An experienced surgeon can discuss this with you fully and computer imaging will be a big help in communication. Sometimes I have done the augment first and then a lift later if necessary, when it would be much more accurate with minimal scarring.

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing. Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
With regards to your specific question, there will always be variations in measurements from one examiner to the next. The take away is that both feel you have a narrower frame (a claim bolstered by your photos). Given the width limitation, a HP device will deliver a more reasonable volume in this more limited space. It is also important to remember that small incremental volume changes rarely dramatically impact the final result (44 ml is a shot glass).
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and your surgeon create your custom surgical plan.
As always, discuss your concerns with a board certified plastic surgeon.

I would recommend an implant with a breast lift. This would create volume and reposition the nipple-areola complex over the new breast mound correctly. You need to see a very experienced American Board of Plastic Surgery certified surgeon. Ideally, this surgeon has also completed a fellowship accredited by The Aesthetic Society.

Thanks for your question! A high profile implant will look a little less projecting once its in your body. However, if that freaked you out, I would suggest trying on a moderate profile as well. It can't hurt to know all of your options. Good luck!

Dear alysalvagni,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient.
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.


Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Hello and thank you for your question.
It is difficult to provide a specific recommendation without physical examination, as characteristics other than base width may influence implant choice, However, you may find it helpful to consult with a surgeon who utilizes VECTRA three dimensional imaging. I use it for all my breast augmentation consultations. It allows the patient to see accurate simulated results utilizing a variety of different implant volumes, projections and manufacturers. I find that sizers placed in a bra often look overly projected and do not always simulate natural results. Good luck. I hope this helps.

I would not recommend an anchor lift for you. The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained. Later, fat transfers or small implants can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

In my opinion, moderate or lower profile implants are usually a good choice when also doing a breast lift since lifting the breast tissue will also increase projection of the breasts. The only times I use a high profile implant is when a large implant size is being used (in order to keep the implant from becoming too wide) OR when the patient wants a very round look. The goal pics do look more like a high profile look, but they could also be consistent with a moderate plus projection. They all look like very fresh post op photos, which always show the breasts as higher and tighter than they ultimately will be.