Will 420cc implants cause double bubble? (Photo)

Good morning,
I think textured anatomical implants are a terrible choice for you- and there will definitely be a waterfall issue if you do not also have a donut mastopexy at the same time. I recommend a donut mastopexy to lift your nipple position, tighten your skin, and reduce your areolas, as well as submuscular augmentation with round smooth implants. Textured implants have been linked to a weird lymphoma of the breasts (BIA-ALCL) and should not be used until we have a better understanding of the causation.

420 cc implant are quite large and placed under the muscle will most likely extrude inferior and laterally. The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Dear MzWolchar,
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

I use smooth round implants placed behind the muscle for better upper breast fullness, avoiding the implant edge, and fewer long term problems like late seromas. Placing the implant behind the muscle will give the anatomical look as well. Plus, the muscle helps support the weight of the implant.