500cc too much for one-stage augmentation and full lift? (photos)

Breast augmentation with lift is as hard as it gets in aesthetic breast surgery. The two components of the operation work against each other: if we do a lift and want it to stay up, why would we place a weight (i.e., an implant) in the breast? The larger the implant the faster will the lift stretch out. Moreover, no one knows how to fix the underlying problem, which is the quality of the skin. No matter how tight the surgeon makes the breast in the operating room, the patient takes home the same damaged skin. Your photos suggest your skin is severely compromised. I would be concerned that 500cc devices would prove far too heavy for you, and that your lift would stretch out very quickly. I recommend you reconsider your size choice. All the best.

Thank you for your question and photographs. I think that your concerns are valid. A 500cc implant is large and your photos demonstrate skin that has lost its natural elasticity. You're at an increased risk for re-stretching. I would have a frank discussion with your surgeon about the risks of a large implant. In my office, a patient with your anatomy, would be offered a two stage augmentation and breast lift (mastopexy). Stage I: full breast lift. Stage II: 3-6 months later, conservatively sized breast augmentation to add volume and give more fullness at the upper pole (top of the breast). If you have concerns about your treatment plan, have several consultations with experienced plastic surgeons to hear all of your options.

Thank you for your pictures and questions. I think that a 500 cc implant is a large choice for you. That does not mean it is a bad choice, but it is certainly large and you will be prone to all the downstream effects of choosing a large implant. In addition, your skin appears to have a strong propensity to stretch and this would worry me about such a large implant. In regards to doing the implant and the lift in one stage, I tend to be on the conservative side and I would not advise it in your case. With your stretchy skin and that large and heavy of an implant, I think a one-stage procedure in you is very high risk. I would advise having a lift first and let that heal. About 3-6 months later, then I would try on sizers all over again and approach your case like a standard augmentation and then see what size you ultimately want once things are lifted to a new position. You might find that when the position and appearance changes, your goals in terms of size will change. Hope this helps!