500cc implants, wanting to go up to 800cc...possible lift also. How do I achieve the high cleavage I desire?

In general terms - a larger diameter breast implant will raise the apparent top of the breast and reduce the space between the breasts. An in-person exam in crucial to explain these concepts and review your options.

Thank you for your questions. Pictures or an in-person consultation would be helpful to discuss your current situation and your goals. The bottom line is that the implant needs to be placed beneath the breast mound. If your nipple is in good position, then a lift will not help that. You cannot change the position of the breast on the chest wall. If you want more volume overall, then that might be achieved by changing your implant, as long as that implant is not too wide for your breast width. In the end, your torso length may be significantly more than your breast width, and so having "higher cleavage" may not be a realistic goal for you. I would discuss revision options with your surgeon and go over whether increasing the size of your implant will get you closer to your ultimate goals. Hope this helps!

I appreciate your question.



The size of implant best for you  is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

Silicone will give you a fullness at the top (upper pole fullness).



Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.



Anatomic gummy bear implants might be a good choice to give you volume.



These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.



During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.





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



Board Certified Plastic Surgeon



#RealSelf100Surgeon



#RealSelfCORESurgeon

Thank you for the question. Definitive advice would require viewing photographs or in-person evaluation.  Generally speaking, what type or revisionary breast operation you should undergo to achieve your goals will depend on your current physical examination. Sometimes, adjustment of breast implant capsules (capsulorraphy) and re-augmentation suffices.  Sometimes, when a patient has breast ptosis, breast lifting is also necessary.  Again, consider posting photographs with your next question for more specific advice.Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery (regarding breast implant size/profile selection) 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 “high cleavage” or "D or DD 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 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 ( after the use of temporary intraoperative sizers). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient.







I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.

Without photos to know your current body shape there is no way we can offer suggestions for changing that shape. But I suspect what you want is achievable only with a bra as you have suggested. If you resubmit the question with your photos be sure to include photos of models with your wish look. The models should not be in a bra or swimsuit as then we have no idea what their anatomy is or if it would be achievable for you.