Size 36A with Tuberous Breast, Tried on from 400-650ccs. Nervous About Size? (photo)

If you are experiencing hesitation, it is best to go with your instinct and stay on the smaller side. With breasts that are tuberous, they are usually higher up on the chest. In this case, it may be best to go with something smaller.

   Your breasts certainly have elements of constriction, and some degree of release and scoring will be needed to accommodate a 300 or 400 cc implant.  A 600 cc implant would not be a great choice given your current anatomy but I have made this work in similar situations.  Larger implants tend to have more long term complications as well, and your surgeon should make you aware of them.  A 600 cc implant will make you larger than your goal pic by at least one cup size.  Kenneth Hughes, MD Los Angeles, CA

Given you have a tuberous breast shape, you may want to consider a smaller implant.  In addition, you may want to consider the form-stable Allergan 410 implants.  These implants will help improve the overall shape of your constricted breast.I consider two factors when selecting implants for my patients:1.Dimensional planning2.Gel Implant Sizing systemDimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. However, there are some limitations of what size we can recommend. For instance, some implants may just be too big for a narrow chest wall. Your surgeon can review this with you during the consultation.Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for. This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look. Hope this helps.Best wishes,Dr. Basu

It is always safer to place a smaller implant with the initial tuberous breast correction.  You can always come back at a 2nd stage more safely to add more volume.   In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Dr. Gill

 Thank you for the question and picture. Although online consultants will not be able to provide you with specific enough advice, some general thoughts may be helpful to you.

 

The best online advice I can give to ladies who are considering breast augmentation surgery 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're 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. I have found that the use of words such as “natural”  or “full C” or "huge" 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.





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.




I hope this (and the attached link) help.

I advise my partial or even full tuberous patients that more than one surgery may be needed to achieve the desire appearance. You need further pre operative discussions! 

First with tuberous breasts they have a tight lower pole. Putting in very alrge breast implants may not work.  Best to stay on the smaller side at least the first time our and correct the herniation.  If you want to go bigger at a later time, it might be possible. An exam would be helpful.

There is no substitute for a face to face consultation, but based on your photos and history size should be less of a concern than the final shape. Constriction of the breasts is not a simple matter of inflation with an implant.  Your surgeon will need to adjust the breast tissue and set the implants in a way that the implants can help stretch the breast tissue as well.  This will take time, and going very large can make the final result far less predictable.  In some situations it is better to go with a modest size to acheive a nice shape and then, if you still want to do so, go larger in a second stage once the pockets have relaxed and the tissue has been stretched.  Best of luck to you.

I would compromise on size for a more normal looking breast. 

I would estimate that the difference between your size and the "goal" photo is closer to 300 cc. 

Part of the problem with the tuberous breast is the high breast fold. If you violate the fold, there is frequently an indentation on the implant from the original fold. If you use the fold as it is, you will need to use a more modest size implant, but will have a more normal looking breast. I would steer clear from an implant as large as 600 cc. All the best.