Need help with picking the right size implant/revision (Photo)

Dear Inventive345746,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Thank you for your question. Many years ago, I pioneered a technique specifically for patients like you termed "Reductive Augmentation". This involves an internal bra-capsulorrhaphy, mastopexy-lift, and excision of the lower pole breast tissue. You should be able to have a beautiful appearing breast with this technique. Best wishes to you.

At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

I’m not surprised that 600 cv is too large. If you have a lift done I would choose an implant around 350 plus or minus.

Do not go larger, but go down in size. with larger implants you will just thin and stretch your own tissue more and will sag with time. I would suggest going down to 300 cc's, placing them behind the muscle and lifting your breasts.

Based on your photos, I agree downsizing to a 450 cc high profile implant with full mastopexy or lift is indicated expect fees to range from $8000-$12,000. Best virtual consult with.

Your post is difficult to interpret.
It’s hard to make sense of the pictures you included.
To make an assessment regarding the outcome of any plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
If you don’t have a complete set of before, and after pictures, then ask your surgeon to forward the pictures they took.
at a minimum we need one frontal and one sideways view of the left and right showing before and after preferably taken similar angles, like your doctor would have done in office.
Breast augmentation outcomes are based on three variables.
The first is the patients candidacy for the procedure. The second is the selection of implants in regards to type shape and size.
The third variable is the surgeon ability to place the implant in the correct anatomic location.
I don’t think anybody is going to be able to give you useful information based on what you’ve presented.
I suggest you relying in person consultations.
Follow up with your provider and schedule a few in person Second opinion consultations with other plastic surgeons in your community to get confirmation of what your doctor is recommending.
It’s very important for people seeking cosmetic surgery to have a clear understanding of their own candidacy for the procedure they are contemplating.
Variables that affect breast augmentation surgery include breast asymmetry, breast sitting wide on the chest wall, breast divergence, breast ptosis, etc etc.
Ideally plastic surgeons should explain your candidacy for the procedure and for those who are not ideal candidates the variables that limit the outcome should be explained clearly to the patient so they have a good understanding of what outcome is going to look like.
Good luck,
Matt Hagstrom MD