5'6", 152 lbs, 36C - Realistic expectations...? (Photo)

The term "realistic expectation" may be relative to some. But am I being unrealistic about the type of results I am able to achieve with breast augmentation? What procedure(s) would you recommend? Note: I have reservations about scaring and worsening of existing stretch marks. My current pics and "wish" pics are attached for reference. Thank you!

Doctor Answers 23

Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I appreciate your question.

From your photos, it appears that you would benefit from a lift along with augmentation.  A breast lift would reposition your nipples and reshape your breasts, giving them a more youthful appearance.  An augmentation would increase volume.

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



5'6", 152 lbs, 36C - Realistic expectations about breast implants...?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question.  You have mammary ptosis and will require a breast lift with a vertical component in addition to breast implants.  To understand the risks of not having a breast lift please read below:

Depends on the procedure you are talking about

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

To best achieve the look in your wish pics you would need a full breast lift and an implant.   You have a significant degree of breast ptosis.   Implants alone would result in either an abnormally low breast or a misshapen breast with a double bouble appearance.   I know you do not want scaring, this is a common concern prior to surgery, but unfortunately it is the trade off for a better shape.   

Reps B. Sundin, MD
Washington DC Plastic Surgeon
4.8 out of 5 stars 33 reviews

You might also like...

Realistic Expectations relative to desired results

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Thank you for your question.

It is in your best interests to have an in-person consultation with a board-certified plastic surgeon to learn about your options and gauge an understanding of whether you have realistic expectations.

With your current pictures, it is clear that you are experiencing ptosis (sagging) that requires a lift. Not getting the lift, and only opting for a breast augmentation will increase the risk of bottoming out, further sagging, double bubble deformity, and worse long-term results.

It would be my recommendation that you ask for an augmentation mastopexy if you want to achieve results similar to those in your desired pics. The surgeon may choose to do a circumvertical or anchor type skin excision to lift the breasts, and steps will be taken to minimize the scars.

In the consultation, share all your motivations for surgery, expectations and goals with complete honesty to avoid miscommunication and post-operative concerns/regrets. Be as specific as you can about what you like regarding your breast and what you don't like. Ask your surgeon about their experience with the procedure you want, and review photographic examples of the surgeon's work on patients who match your current looks, and assess the work to see if it meets the aesthetic ideal that you are hoping to achieve. 

Hope this helps

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

5'6", 152 lbs, 36C - Realistic expectations...? (Photo)

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Advice I give patients is that their 'wish pics' should be before-and-after pictures where the before picture looks similar to their breasts and the after is a result they like. 

Your wish pics are women who had pre-op breasts that were very different from yours, particularly with regard to nipple position relative to the breast fold. Your nipples are below the fold and pointing downward, and therefore you will need a lift at a minimum to get to an ideal shape. You may also choose to have an implant placed to increase your breast volume. From the pictures you attached, it looks like your aesthetic is for a larger and more fake-looking breast, so you are likely headed down that avenue as well. 

Go see a board-certified plastic surgeon and show them a handful of before-and-after pictures that look like you before and what you want after. This will greatly facilitate the discussion. 

Hope that helps!


Christopher D. Knotts, MD, FACS
Reston Plastic Surgeon

Breast augmentation and lift

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hello and thank you for the question and the photos. Based on your photo, you would benefit from implants and a full lift. You have some asymmetry as well. The right breast is larger and lower than the left, and during the lift I would also recommend a modest reduction of the breast tissue on the right. 

You will have the traditional anchor type scar. Although no one wants scars, there is simply no way to do this without scars. Such techniques that try to hide or minimize the scars, typically fail in that it does not address the core problem of too much skin or nipple malposition. 

Combining breast augmentation and lifts are commonly done. It typically takes me about 2-3 hours to complete under full anesthesia. You should factor a week off of work and about a month out of the gym. 

You should seek several consultations with board-certified plastic surgeons in your area before making any decisions.

As always it is best to be healthy, no smoking, and to make sure any health concerns you have are managed by your primary care physician.

Best to you

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

Breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hello and thank you for your question.  The best advice you can receive is from an in-person consultation.  With that being said, based on your photographs, the best shape and contour could be achieved with an implant and a wise pattern breast lift. Your nipple sits below the inframammary fold and without a lift in addition to the implant, this will not have a natural shape.  A wise pattern lift with an implant can result in a very nice shape if good technique is used.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   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.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 174 reviews

5'6", 152 lbs, 36C - Realistic expectations...?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Hello dear, thanks for your question and provided information as well, you will need a lift, to get rid of extra skin, and get better shape, I recommend you it consult a board certified plastic surgeon that can help get the appearance that you wish.

Tania Medina de Garcia, MD
Dominican Republic Plastic Surgeon
4.6 out of 5 stars 441 reviews

Breast lift with augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You would most likely get the best result with a full breast lift and breast augmentation. Please seek an in person consultation with a board certified plastic surgeon in your area. Be sure to express your goals and expectations to your chosen surgeon. In my practice in the San Francisco Bay Area I have come to the conclusion that the happiest patients are those that have realistic expectation on what a procedure will and won’t do for them. Good luck!

Dean Vistnes, MD. 

Vistnes Plastic Surgery 

San Francisco Bay Area

#realself #drdeanvistnes #breastlift #breastaugmentation

M. Dean Vistnes, MD
Bay Area Plastic Surgeon
4.9 out of 5 stars 51 reviews

5'6", 152 lbs, 36C - Realistic expectations...?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

To achieve the look that you want, the nipples need to be elevated relative to the breast tissue. No one wants a lift. However, if that is what you need, then having an augmentation without doing it will leave you an your surgeon disappointed in the final result. Good luck!

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.