Going From 375 to 600cc (Photo)

Question

I have been advised that since my nipple is low and my ideal pics have the nipple high on the breast mound, revision of the pocket will be difficult. My dr, dr Buchanan is saying that with the bigger implant it will raise my nipple positioning. He is saying he will use the same imframammary incision too. Is this untrue? Please if anyone knows dr buchanans work and experience please advise me if I should go with someone else!

Elizabeth Slass Lee, MD · Answer

Breast revision surgery can be scary. Some generic advice is that nipples are not raised by putting in large breast implants. If you lower the crease underneath the breast, the nipple may be made to look higher, but the scar you already have will also no longer be in the crease but will be higher on the breast. Also, "double bubble" problems happen more frequently when the crease is lowered. The best way to raise the nipple is through a breast lift or mastopexy procedure. The asymmetry in the location of your nipples can also be corrected with a breast lift. The main reason to increase the size of your implants would be to make your breasts larger. Do you want your breasts to be larger than they are? The pictures you shared show very large breasts. If what you like about them is the location of the nipple, than a breast lift is more likely to get you what you want. The implant size increase you are considering will make your breasts much larger than they are now. Your questions are good and any surgeon you are considering working with should answer them for you and should help you define your goals. Bigger is not always better. Make sure you choose a surgeon certified by the American Board of Plastic Surgery. If you feel your current surgeon has not answered your questions adequately, consider a second opinion. If you and your surgeon are not on the same page, you risk being unhappy with the result. Good luck

Ritu Chopra, MD · Answer

In my opinion this methodology of putting a bigger implant on to gain a lift in the breast is flawed. Perhaps in the first few months the breast may look slightly lifted but in the long run putting in bigger implants will result in a poor result. The best thing to do is go on different consults to get other board certified plastic surgeons views. Generally putting in a bigger implant will not get you a lifted breast. I hope this helpsRitu Chopra MD

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.In my opinion you need to reposition the implant and the breast better on the chest wall. This can be achieved with a larger implant (maybe anatomic) but you will also need a lift to bring the nipple and breast tissue up higher.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

Kenneth Hughes, MD · Answer

An exam and preoperative photos would be useful in providing recommendations.  Depending upon the extent of dissection of the pocket, there may be opportunity for improvement and positioning.Kenneth Hughes, MDBeverly Hills, CA

Gerald Minniti, MD, FACS · Answer

Hello,I don't know your doctor, but you will not either get elevation of the nipple on the mound nor will you get symmetry of your nipple position (one is lower than the other because one breast is more sagging).  Surgeons that specialize in cosmetic breast surgery including lifts, reductions, and revisions, can tell you that volumetric increases do not yield upward rotation of the nipple on the mound itself; for any increase in the nipple's height that does occur, the mound increases as much or more.If you want bigger breasts, there's no doubt that larger implants will help.  But if you want breasts that have a 'perky' appearance, i.e. high riding nipple, then you'll need a breast lift too.  Go on some consults with specialist and look at their results, and bring the clinical before photos of yourself so they can find similar patients in their gallery. See if any surgeons just did an augmentation.Best of luck!

Yuly Gorodisky, DO, FACOS · Answer

A larger implant will make you larger but it may or may not give you the look you seek in your desired photos.  You should be examined and based on your skin, dimensions, and position of the areola the plan for your surgery is determined, which may include a lift to improve your shape.

Michael R. Schwartz, MD · Answer

Thank you for your question.  You have brought up two very important issues.  First, you should never be a size that you do not want to be.  Going from 375-600 cc will make you much larger.  If this is not your goal, don't use this as an attempt to get a prettier breast.  It will not raise your nipple, and it will only stretch your tissue and sag sooner.  Second the only way to significantly raise a nipple is to do a lift.  If the implant is positioned lower through the same incision, then the scar will have to move up higher onto the breast and be more visible as well.  Your best bet is to seek out a few more consultations from experienced Board Certified Plastic surgeons.Best Regards,Dr. Schwartz

Lisa Cassileth, MD, FACS · Answer

There are soooo many things to say here. First of all, the girls' breasts that are your "ideal breasts"are 1 - girls with bigger lower implants 2- girls with less breast tissue, and the tissue they have does not sag 3- there is actual semen on some of the breasts you have selected. Hmmmm...     This all tells me a lot. First, you clearly want to upsize, as all these boobs are bigger. Bigger implants often misbehave as they are heavy. They contract, move laterally, overdissect the pocket. I know as I revise these all the time! So don't go too big. I think 500 has a sexy look with lower risks. Go as small as you can tolerate.    Second, your implants are too high. You have that saggy boob hanging off your implant look. The pocket needs to be lowered. All your porn shots have a very low pocket, you can tell because the nipple to inferior mammary crease distance is super long. Your surgeon needs to be good here, as you don't want your boob, then another bulge under that which is the implant... a problem called a "double bubble".     Third, consider keeping your same size and just lowering your implant. Porno boobs are not fun for the owners for long- you spend a year or two with guys staring at your tits and then you realize you can't run, do a push up, and then you get married and no one wants to do a play date with the porn mom and they all get them downsized so they are not "that girl" as my clients say. Easier to get great long lasting boobs now and keep 'em. And stay off the pole.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after previous breast operations. Choosing to proceed with revisionary breast surgery can be anxiety provoking for patients in your situation. Even with careful selection of your plastic surgeon, every operation does carry small, but real, risks of complications. However, having said that, careful selection of your plastic surgeon will maximize chances that you will achieve the outcome you are looking for. Ultimately, whether or not to proceed with revisionary breast surgery will be a very personal decision that only you can make after very careful consideration. You will need to weigh your degree of concerns regarding your breast appearance against the potential risks/complications associated with additional surgery.

Generally speaking, the best online advice I can give to ladies who are considering revisionary 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 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. I have found that the use of words such as “natural” or "C or D 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. 
3. Once you feel you have communicated your goals clearly,  allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.
I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.

Michael J. Brown, MD · Answer

Hi,

Thanks for posting your question. I am happy to try and help you. It is
important to remember that a board certified plastic surgeon will be your best
resource when it comes to an accurate assessment of your situation, and
concerns.

Having said that, you should speak to your plastic surgeon. Online consultants
are not the appropriate source of information for you; your plastic surgeon
should be your resource when it comes to these concerns. This is
important because every surgeon has different perspectives, the only one that
should be important is the one that has examined you. What he is saying to you is not incorrect. Without examination, there is no 100% way to answer your questions. If you have concerns or doubts, then go on another consultation.

Best wishes,

Dr. Michael J. Brown 
Northern Virginia Plastic Surgeon

Going From 375 to 600cc (Photo)

Answers (13)

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