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

Question

I’m 42, 5’10 and 145 lbs. currently have 600 cc silicone implants and I’m a G cup. I hate them because it makes it hard to wear anything properly and they have no shape on the inside and too round on the outside. I’m planning to get lift and exchange but I don’t know what size to do. The 3D imaging showing my before picture just doesn’t seem accurate to me. I’m unsure if I have wide set breasts. Would like to be a D to double D with roundness on the inner pole being a goal

Daniel Barrett, MD · Answer

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

Paul E. Chasan, MD, FACS · Answer

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.

Gary M. Horndeski, MD · Answer

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.

Ronald J. Edelson, MD · Answer

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.

Connie Hiers, MD, FACS · Answer

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.

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

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Answer: Breast lift

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

Answers (7)

Answer: Breast lift

Answer: Breast lift

Answer: Implants

Answer: Implants

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.