I'm considering 700cc saline implants. Which profile & placement would help me reach my goal? (Photo)

Question

Stats are: 42 yrs, 5'7", 165lbs, 38-33-40, chest wall is 17", collar to nipples is 25" & 24 1/2". Breasts are deflated due to breastfeeding & fluctuating weight. Had consult, Dr did exam & measurements, said nipple position & breast tissue is good, doesn't feel I need a lift. I want fuller, rounder, and larger breasts. He recommends implants in the range of 600-800cc. I'd prefer saline. We didn't discuss profile or placement of implants but I'm curious as to what might give me the best results?

Thomas A. Mustoe, MD, FACS · Answer

Thanks for submitting your question
and photos. Based on your height, weight, and chest wall measurements and goal
pictures, a size range of 600 to 800 cc is realistic, and your frame could handle
that size with a nice result. You have enough breast tissue to get a nice
result with saline without being too aware of the implant, but it should
definitely be placed in the submuscular position with the dual plane technique,
which allows for a more natural appearance. It also helps with filling out of
the inferior pole of the breast, combined with the more natural long-term
appearance in the superior pole that a submuscular implant gives you. With the
goal picture that you show, I would recommend a moderate plus implant, which
will have a less rounded look superiorly and more superior pole fullness to the
larger diameter of the implant, but this discussion is best done in person. It
sounds like your surgeon has considered the appropriate factors. Good luck and
best wishes.

Frank J. Ferraro, MD · Answer

By your dimensions it would seem that you can handle a larger implant. Preop measurements are a starting point but using sizers during surgery gives the most accurate determination of fit

Kenneth Hughes, MD · Answer

700 cc implants are very large for almost anyone.  I think that a lift would be indicated based upon the single picture.Kenneth Hughes, MDLos Angeles, CA

Thomas Trevisani, MD · Answer

Generally speaking- I am not an advocate for breast implants larger than 600cc- except in very rare circumstances. My primary opinion is - breast lift ( mastopexy) with implants under the muscle to give you your best looking and longest lasting result. You are borderline for lift- but if you choose not to lift- be prepared for continued sagging over time, especially with these massive implants that you propose

Tom J. Pousti, MD · Answer

Thank you for the question and pictures. 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. Generally speaking, I think that it is in most patients best interest to have breast implants placed in the sub muscular (dual plane)  position. You will find lots of information about the pros/cons associate with different breast implant positioning on this website.  
Otherwise, unfortunately, online consultants will not be able to provide you with specific enough advice (regarding specific breast implant size/profile) to be truly helpful. Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant type/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. In bra sizers can be useful communication tools also. I have found that the use of words such as “natural” or "D or DD cup" 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 the communication process.
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.

Jourdan Gottlieb, MD · Answer

Based only on the one photo, I would suspect that another surgeon might recommend a lift.  If you don't get a lift, be prepared for the possibility of wanting one after implants, and that, of course, can be done.I would suggest considering silicone implants for a more natural feel. Most surgeons will recommend placement behind the muscle. Although I occasionally use implants as large as 700cc it is seldom my recommendation. As to profile, that would depend upon a measurement you have not included--breast width.  As a rule surgeons prefer not to use implants wider than a patient's breasts. You have some homework to do. Best wishes.

Robert A. Hardesty, MD, FACS - Account Suspended · Answer

Thank you for your questions, your photo and goal photos.The "goal photos" should be nude. Clothes can alter the apparent breast shape (push up bra as a example)There are many decisions in the process of trying to reach your goals. Only one of them is the correct choice of implants. Thus will focus on only implant selection.my approach is to work with the patient closely regarding implant selection1)  to choose the volume YOU desire IS based on in office sizers and at home using "rice in a nylon".  measure the rice. 1 oz = 30cc.2) the base of the breast should be close to the base of the implant. Reason, if implant base too wide it will result in breast tissue on side of chest. If too narrow will not give as much cleavage.3)the difference between high profile (narrow base and slightly more projection) and moderate profile (wider base and slightly less projection) is minimal in projection difference but can be significant in base width.You also need to consider the filler material: silicone gel or normal saline.Based just on your one photo and to reach your goals. I believe you would need a lift.most likely  a periareolar lift that would remove stretched skin and place the nipple areolar complex in the correct position.I would recommend another consult with a Bd. Cert. Plastic Surgeon who has experience in both breast augmentation and lift  (mastopexy).My warmest regards,

Ronald V. DeMars, MD (Retired) · Answer

Thanks for including good photos. You have quite a lot of natural breast tissue so I doubt you would need anything close to 700cc, that seems extremely large, even on your frame. It might be more appropriate if you had a lot less of your own tissue. But no one here can give a very good recommendation on implants without an exam, so maybe you should get 2-3 consults.

I'm considering 700cc saline implants. Which profile & placement would help me reach my goal? (Photo)

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