How to get the roundest possible shape when you already have medium breast size? (Photos)

Question

I've always wanted a very plastic look, rounded, ripped, hard breast, like pornstars (e.g. Kristhin Gomez), but I already have a medium size sagging natural breast. Two years ago I talked to a surgeon and he told me it would look bad to place a round high profile implant above my natural breast. He told me that to get that round ripped look, I should have a mastectomy before, but I still don’t know where to find info or surgeons that do mastectomy + breast implants for cosmetic reasons...

Derek Fletcher, MD · Answer

Achieving round breast shape is a matter of selecting the correct breast implant. Please post standard photos of your breasts (frontal, oblique, and side views) to I can give you the most accurate assessment and recommendations.

Wayne I. Yamahata, MD · Answer

I believe most plastic surgeons would agree that your "current look" is aesthetically better than your "desired look." I personally would not recommend a mastectomy, hoping to improve your appearance. The risks far exceed the potential benefits.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. A large portion of my practice is dedicated to breast surgery and breast revision. Over the years, I have developed a technique known as " reductive augmentation ".  This includes reaugmentation, internal bra-capsulorrhaphy, mastopexy-lift, and excision of the inferior pole breast tissue. You are an excellent candidate for this. Best wishes to you.

Zoran Potparic, MD · Answer

Based on these photos, you seem to have naturaly very nice breasts. One option to achieve bigger, round breasts is to proceed with augmentation with very large implants. Due to a significant amount of breast tissue, for many years, until atrophy of breast tissue takes place, you will not have a "fake breast look" which you seem to desire? Other option would be to reduce significantly amount of breast tissue by means of breast reduction (liposuction is excellent option for that), and use larger implants to create desired look. You will have to contact possibly few board certified plastic surgeons to find one who would be ready to do it. Hope this helps. Good luck.

Ram Kalus, MD, FACS · Answer

Your “current look” is beautiful and natural. Your desired look is distorted. You are unlikely to find a board certified plastic surgeon willing to perform bilateral mastectomies and reconstructions for cosmetic reasons. That said, you may find a NONE board certified practitioner with little experience and poor training and skills (a charlatan) who would be happy to do what you wish, as long as you can pay for it.

Your wishes suggest that you have some unhealthy concepts of what is beautiful or desirable, and it would be in your best interest to discuss this with a professional counselor (psychologist or psychiatrist) to explore these thoughts further.

Word to the wise, do not follow your current instincts. Best of luck to you.

Daniel Barrett, MD · Answer

Dear Cool93490,
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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Do not do the mastectomy. Your "desired" look is not pretty, will not stay that way, is hard, and will ruin what breast tissue you have.  Don't ruin your breasts.

Richard P. Rand, MD, FACS (retired) · Answer

First of all, it is crazy to propose a mastectomy on you. Period. Second, you have perfect, natural breasts. If you try to achieve the "look" you want, you will destroy them and potentially have a lifetime of problems and regrets.

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