37-yr mum of 3 w/34-36D; I just need to know if implants will give me the fullness of when I was 20? Or make me huge? (Photos)

I have had a few consultations already & I am opting for inframammory incision, a subglandular implant, around 500cc, silicone gel, as I have a good amount of tissue. Another option is a lift plus smaller implant. What do I do? I don't really want them any bigger. I am so excited about my surgery date but felt it a great time to get reassurance from professionals. Do you need any more specifics from me to tell me what you think are my best options? Looking forward to reading your replies. TIA!

Doctor Answers 9

Find the right surgeon

Far more important than the technique is the skill and experience of your plastic surgeon. Choose your surgeon rather than the technique and let them explain why one technique may be better than another. 
See the below link on some suggestions on finding the most qualified Plastic Surgeon for a  Breast Augmentation .

37-yr mum of 3 w/34-36D; I just need to know if implants will give me the fullness of when I was 20? Or make me huge

It is hard to say if you will have the appearance you had when you were 20 without seeing pictures of you then. I will say that an implant above the muscle will make you larger. The upper part of your present breast will be rounder but the breast mound will stay exactly where ti is now. You will not be any higher on your rib cage without a lift.

Julio Garcia, MD
Las Vegas Plastic Surgeon
4.8 out of 5 stars 26 reviews

Breast lift or implants alone

Breast Lift with Implants or Implants Alone One of the more common scenarios that we as aesthetic plastic surgeons deal with in cosmetic breast surgery is the patient from either weight loss, or post pregnancy has a little bit of drop of the breast off of the chest wall that we call ptosis. The question then becomes in the patient's mind, can we just fill the space with an implant and create a youthful looking breast. It all depends on what the patient's perception of youthful is. My patients, more than likely, would like to have upper pole fullness of the breast without the necessity for wearing a push-up bra. In these situations, a breast lift plus an implant both centers the nipple and areola complex on the breast while replacing the lost volume with an implant. Most patients’ hesitation in doing the breast lift as well as implants, are the potential for bad scars. In my experience, we talk a lot about the scars of a breast lift preoperatively, but hardly ever in the postoperative phase. It seems to me, that when the breast is up high on the chest wall, youthful and perky, that one does not even see the scars. Most of the time, these incision lines heal uneventfully anyway. In the small chance that the scars are more red or thicker than one would like, we have many options in lasers, light sources, and laser assisted drug delivery techniques to mitigate against unsightly scars. Sometimes, patients who I've seen have seen other physicians who have recommended simply placing a large implant to "fill the space". This seems to be a very temporary fix for the situation in that the stretched out soft tissue that the implant is placed into, usually will allow very rapid descent of the breast, such that in just a few months, it looks like a bigger version of the breast that they first started with. They will then sometimes have a secondary mastopexy, and at that time, I would often recommend that they replace the very large implant with a smaller one. In my opinion, a large lift, meaning taking out as much of the stretched out skin as possible, and placing a more modest size implant will make a breast that will remain perky and up on the chest wall for a long period of time. In my opinion, perky breasts, not necessarily large breasts, look youthful. Patients will then ask, "why then does Dr. so-and-so tell me that I can just have implants?" My answer to this is very simple. It is far easier in most plastic surgeons’ skill sets to place a large implant then do a breast lift with an implant. The simultaneous lift and implant procedure is a little more challenging in that you're trying to do opposite things at the same time. One, you're trying to make the skin envelopes smaller and at the same time make the breast larger. One easy way to decide whether a lift is good for you, is to see your image in 3-D on a Vectra camera system. In our office, we can then compare two images: one with mastopexy with implants and the other with implants alone. In that way, both the patient and plastic surgeon can see what the difference in the look of both procedures are. Usually when implant is placed only, and a breast lift was really needed, what the patient will see is a breast that is falling off of a properly placed mound that's higher in the chest wall than the breast is. The breast seems to be falling off the implant. They will commonly squeeze the end part of their breast and ask,  “why hasn't the implant filled this space out?” For me, the in between operation is to use a tall shaped implant. These anatomically shaped implants can create the illusion, that although the nipple has not really been raised, that the nipple is now more centered on the breast. While these implants do cost more than round implants, it still less expensive than adding a breast lift. All things considered, it's best to consult with a few talented and busy cosmetic breast surgeons to get different opinions. Good luck with your decision.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Implants

You will not be happy with sub glandular implant only. You will have a large hanging breast. I suggest you consider a lift only, and implants later only if you want to be bigger.Good luck.

Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

Breast lift vs augmentation

Hello and thank you for the question and photos. Based on the photos, a breast lift would be the best option. Based on your statement, "I don't really want them any bigger", I would be very concerned about a 500 cc implant. Because you will be MUCH bigger after this surgery. Since we don't have pics of your 20 year old self, it's hard to answer that question. I would be cautious about the implants. 
You can always opt for the lift first and see if that is enough to make you happy. You can always add implants later if you decide that you actually want to be bigger. As always, best to be healthy, no smoking, and make sure any health care concerns you have are managed by your primary care md. 
Best to you. 

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 16 reviews

37-yr mum of 3 w/34-36D; I just need to know if implants will give me the fullness of when I was 20? Or make me huge? (Photos)

Assuming you don't want to be any larger, a breast lift alone would be a good option.  In some cases another option may be do do a lift, remove some of the breast tissue and place a moderate size implant under the muscle.  This may reduce the rate at which the sagging of your breasts recurs as you get older. The highly cohesive Gummy Bear implants work exceptionally well in many of these cases.

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question. From your photos, it appears that you would benefit from a breast lift along with augmentation.  A breast lift would reposition your nipples and reshape your breasts, giving them a more youthful appearance. 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 plastic surgery. Best of luck! Dr. Schwartz Board Certified Plastic Surgeon Director-Beverly Hills Breast and Body Institute #RealSelf100Surgeon #RealSelfCORESurgeon

Best breast operation for me?

Thank you for the question and pictures. In my practice, I would encourage you to undergo breast augmentation/lifting surgery. Breast augmentation surgery alone will most likely NOT leave you with an aesthetic outcome that you will be pleased with.
Ultimately, you will do well select your plastic surgeon carefully and communicating your goals, questions, and concerns. In other words, careful measurements, dimensional planning, and careful communication will be key.

Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery. It will be important that you educate yourself regarding the pros/cons/risks/complications associated with breast augmentation/lifting surgery. Only after doing so can you make an informed decision whether or not to proceed. You will find a lot of information on this website and on the attached link.

Also, generally speaking, the best online advice I can give to ladies who are considering breast augmentation/lifting 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. Again, have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining which operation and/or 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 “natural” or "C or D cup" or "make me huge" 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. The use of computer imaging may be very helpful during this communication phase.

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. The use of temporary intraoperative sizers with the patient in the upright position makes selection of the best breast implant size/profile relatively easy. I hope this, and the attached link, helps. Best wishes.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.