Will 520cc high profile implants look fake/too big on my 5'2, 135lb frame? (Photos)

Question

Can I go with moderate profile? I want a subtle, natural enhancement. I am currently a 34C. My BWD is 13.5. I would like to restore some upper pole fulness, while still maintaining a natural look. I would like to be a 34D or DD. PS said that I don't qualify for a lift because I don't have enough skin & due to my anatomy he's recommending high profile implants. Because my nipples droop, he's recommending I get at least 520cc to restore volume.

M. Scott Haydon, MD · Answer

Thank you for your question and the photos of you and your wish pics. It is important to not that your anatomy is different form the wish pic photos that you've attached. Your nipple position is lower and there is minimal skin of the lower breast seen below the border of the areola. You have a high tight crease (inframmamary fold) and the implant is going to have a hard time settling down into the pocket without either lowering the crease and/or doing a lift. The goal should be to give you the look and shape that you want, rather than focusing on a cup size. Realize that a large part of the implant (the upper part) won't even be in the cup of the bra. In my hands, I would to a mastopexy and augmentation to try and center the nipple areolar complex on the implant. I would try not to purposefully lower the IMF as there will be potential for a double bubble. You have a fair amount of breast tissue and so I don't think that you need anywhere near a 500cc implant to accomplish the fullness your wish pics show. I would use either a Low Plus or Moderate implant 300-400cc depending on the desired shape. Nothing about a HP 520cc implant is natural or subtle. Best of Luck!

Finny George, MD · Answer

Hi, thank you for sharing your question. You will be able to achieve your wish pic with smaller implants. You may also want to consider a lift to improve nipple position rather than going with a very large implant.

Daniel Barrett, MD · Answer

Dear MamaMiaMakeover,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Chul Hwan Seul, MD, PhD · Answer

When sagging breasts are enlarged with implants without lifting, there is a high possibility that the breast shape will not be good after surgery (Snoopy nose deformity or waterfall deformity) if a moderate profile is used. Rather, using a high profile is advantageous in improving deflection. However, 520cc is expected to be too large and unnatural, and around 300cc seems to be appropriate.
If you do periareolar mastopexy, the sagging breasts will be properly corrected and the shape will be better, but if you do lifting like this, the shape will be fine even if you use moderate projection.

Brian K. Reedy, MD · Answer

Thanks for your question! I think that your plastic surgeon is trying to talk you into a larger implant to help kick your nipple up a little bit. However, based on your goals, I think that you will be larger and droopier than you want to be. I would suggest a moderate profile implant with a lift. Good luck!

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question! Implant sizing is a very subjective and personal process. Could those size implants fit in your frame/measurements? Yes, very likely especially with a higher profile/narrower implant with more projection. Will you be happy with that size implant and the "look" it will give you? Only you can answer that question and your surgeon should do his best to make it so you can answer that for yourself.

If you have not tried on physical sizers inside of bra/clothes, that would be the next best way to determine if you like the look/feel/weight of implants around that size. In my opinion, placing 500cc+ sized implants will not give you a "subtle enhancement" as you refer. It will be very obvious and your breast volume will be 2+ cup sizes larger. Whether you consider it natural is more subjective - yes,  you can make a breast that looks "nice" with that size implant, but it will be up to you and your goal "look" if you are happy with it and consider it "natural."

When patients in my practice choose implants much higher than 400cc+, I also counsel them on the weight of "larger" implants (i.e. it is possible to then have some of the same symptoms that our breast reductions patients have, such as neck/back/shoulder pain). Good luck on your journey!

Luis A. Mejia, MD · Answer

Dear MammaMiaMakeover, thanks for sharing your pictures and concerns, 520cc could be way uncomfortable and will not look natural. After analize your case you look like a great candite for breast augmentation with lift probably using a 325cc work better. But every plastic surgeon has his own techniques and protocol which he recommends to their patients. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia.

Jeffrey M. Darrow, MD · Answer

Thank you for your photographs. At 5‘,2“, a 520 cc implant will look rather large for you.  It would not be a subtle, natural look as you mentioned wanting to achieve.  You already have a fair amount of breast tissue, but your breasts appear to have a Grade 2 ptosis.  Only doing an implant will give you a larger breast with a Grade 2 ptosis, and the added weight will create more ptosis in the future.  From your photographs, it appears that a breast augmentation with a breast lift would be the best procedure for you to give you the added volume that you’re looking for, and elevate your nipple/areola to its correct position.  Seeking additional consultations may help you get a broader outlook. Best wishes.

John L. Burns Jr., MD · Answer

I'd suggest doing 3D breast implant imaging.  The technology can be used to control both volume and profile.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Warren Schutte, MD · Answer

You will need to choose a moderate to larger sized implant to fill out breast envelope and raise NAC's. A high profile implant will aid in doing that and also provide more upper pole fullness. It is important that you try on the 500cc range implant sizers to make sure that you are comfortable with your size choice. If you drop down to Mod Plus, you will lose some upper pole fullness and would likely need to drop down to 425-450cc volume range. The choice is ultimately yours to make.

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