Hi and Thank you for your question. My suggestion would be to only do a lift without an implant. That way you will have a natural look. Your breast size looks like you will end up with a full C without implants. If you want to go bigger then I definitely would not use high profile implants. I would place them under the muscle.
I would select the implant based upon your overall size goals after these are established with trying on sizers in the office. The profile of the implant can then be determined by anatomical measurements to fulfill your goals.
Select a plastic surgeon who performs hundreds of breast augmentations
and lifts each year, has great reviews, and has great before and after
Kenneth Hughes, MD
Los Angeles, CA
you have not told us your bra size but from your photographs, your breasts appear
large. I am not sure implants are
required, instead I recommend a new technique called The Ultimate Breast LiftTM. This technique avoids the ugly vertical scars
of the traditional technique, maintains nipple sensation and the ability to
breast feed. The breasts are reshaped
creating upper pole fullness, elevated higher on the chest wall and more medial
to increase your cleavage. I believe
this technique will give you the results you desire without implants.
Gary Horndeski, M.D.
Thank you for your question and photos. The photo is helpful, but no substitute for an in-person exam. From what I can see, you have nipple/glandular ptosis (sagging) with loss of upper pole fullness and loose skin. Be careful when you request a "natural" look, as breast implants do not impart a "natural" look. What I think most women mean by "natural" is to not look overly fake or have high very round, half grapefruits sitting on their chest.
A breast lift alone, will give you a very "natural" result with a scooped out (concave) upper pole. If you would like more fullness in the upper pole, than an implant added to a lift is a great option. Putting the implant under the muscle will help soften the upper pole so that you don't have a round/fake look. I typically recommend a moderate plus/midrange implant when combining with a lift. This profile is not as projecting as the high profile and will place less tension on the closure, thus lessening your risk of blood flow problems to the nipple and decreasing any risk of difficulty closing the vertical incision. Some patients even need a low profile implant depending on their base diameter (breast width) and desired implant size. Also, a higher profile implant does not lend itself to a "natural" look. One other option to consider is to undergo the breast lift first and then consider an implant at a later time if the upper pole is not as full as you would like.
Seek out a board certified plastic surgeon that will listen to your concerns and make sure you have all of your questions answered. Good luck.
Most of times it is volume/ profile equation of implant determines final look. Based on your photos a breast lift with small moderate plus implant placed in front of the muscle will be best in my opinion. Implant placed behind the breast but in front of muscle tends to blend in with natural breast and two (implant plus your own breast) act as a unit to fill up loose skin of breast more effectively compared to submuscular placement of implants. Cleavage is certainly better with subglandular implants.
Your question about the type of implant is a good one, but one additional option to consider would be to do a full breast lift first-- I think there is every chance that you could be very happy with the results, but if not you could always have an implant placed later. I find this approach can be helpful for patients who are unsure about the type of implant they want or if they want implants at all, and in particular on denser, more ptotic breasts, the 2 stage approach (breast lift and then an augmentation) seems to work very well for many patients. The bottom line is that there are lots of options for you and having a good chat with your surgeon and reviewing all of the pros and cons of each approach is an important step. Great question and good luck!
You should trust your feelings. A high profile implant will not give you a gentle upper pole fullness. My concern about her recommendation has just as much to do with another issue that I suspect: she wants to 'lift' your breast as much as possible with the high profile implant to help the 'small lift', which I presume is circumareolar. First, no implant lifts a breast whose nipple is below the inframammary fold. Second, even a circumareolar lift is not appropriate for a breast with this grade of sagging. Your breasts are already full and heavy, and this lift will put you at risk for many problems including, asymmetric, off-round, or enlarged areola, thickened scars, radial dents in the breast mound emanating from the edge of the areola (pleating), flattening of the breast mound, and persistent sagging.
You need to find a surgeon expert in all aspects of breast surgery including lifts, reductions and revisions. You will get a full, natural, pre-pregnancy appearance to your breasts with a low or intermediate profiled implant and a formal breast lift. Look at some photos to confirm the appearance of potential scarring.
Best of luck!
I rather agree with my colleague who suggests a mastopexy alone. You look like you have plenty of breast tissue. High profile??? Not a good choice IMHO. I like the mod plus by Mentor. Although the new Memory Shape is working very nicely also. But realistically, why not just do the masto and see how you like it. If it is not quite full enough then the surgeon goes in through the old scar under the breast and adds an implant 3 months later. Do it on Thirsday or Fri and back to life on Monday. If you are happy with the masto alone why add the extra issues of an implant? Also, the first question to ask is 'are you happy with your appearance in a bra?' If the answer is yes then by all means don't add an implant now. The only other reason to add an implant is if you breast totally pancake laying on your back suggesting the tissue is extremely soft and atrophied from the kiddos. Good luck. I've attached a video on the subject.
You are correct and should trust your feelings. The moderate profile plus silicone gel implants made by Mentor is specifically designed to produce a balance of breast base width and a pleasing forward profile of the breast. Based on your photograph I believe your concerns about high profile implants are true and justified. You have a moderately wide based breasts and will need the wider base diameter of moderate profile plus breast implants.
It is essential that you express your feelings directly to your plastic surgeon and insist on having the type of implant that you feel is best for you.
Based just on your photo it looks like a full lift is in order, including good internal support of the breast tissue (so not just a skin lift) and that is all . You have more than enough natural tissue to get an excellent shape and then you won't have to worry about a lifetime of maintenance as augmentation patients do.