My breasts are weird and ugly. What do I do?

Dear Thisismee,based on your photos, you would benefit the most from a breast lift. You might also consider a breast augmentation. Determining whether you need simply a breast augmentation versus a breast lift can be somewhat complicated. It depends on a number of factors including skin laxity and current nipple position. Generally speaking, if the nipples are lower than the inframammary line the patient will most likely need a breast lift. If the nipples are at or above the inframammary line we can generally get by with just a breast augmentation depending on the size of the implant the patient wants. I often still using implant when I perform a breast lift because it provides more upper breast fullness after the lift. To be sure a consultation with a board-certified plastic surgeon will help determine what the patient actually needs.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

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 Always insist on a board certified plastic surgeon.

I would suggest a breast lift to help with ptosis and asymmetry and a conservative breast augmentation to add some volume.

I wouldn't classify your breasts as ugly. If you want to change them I would recommend an implant augmentation to fill the volume and a lift to reposition the areola and reshape the skin over the implant.Best

     Whats the best route to go for achieving natural full breasts? That depends if the needs a breast lift or not and on the size of implant they want. The bigger the implant the less natural it's going to look. Now we also have the silicone that are anatomically shaped and that can give a more natural shape, and less of the round shape of the traditional implants. 

     High profile are taller and narrower implants when compared to moderate profile implants of the same volume.The decision is usually based on the patient breast dimensions, amount of breast that the patient can contribute to the projection and I also factor the patients desires. I try my best to also respect the skin quality and elasticity in order to prevent future drooping due to unnecessarily heavy implants

    over or under muscle doesn't dictate what size implant we can use.  The muscle coverage is helpful in very thin patients and seems to reduce capsular contracture according to some scientific studies. Under the breast tissue is the most natural feel and has a less chance of animation deformity when the pectoralis muscle contracts. In most instances only the top implant is covered by muscle and the reset of the implant ends up under the breast tissue.

    What are the basic tips to know if I need a breast augmentation or breast lift? It all depends on the position of the nipple on the breast. The further down the nipple is in relation to the fold the more the chances are the patient needs a lift.

Choose a board certified plastic surgeon who has done a ton of Breast augmentation  and has privileges to do this surgery at a local university hospital. This says his credentials have been checked out by fellow Drs. All surgeries carry risk, talk to your plastic surgeon.
Many surgeons offer online virtual
consultations where you send us your photos to be examined.  Please be
mindful that the in person physical exam is the most important and could
potentially alter your treatment plan.

Thank you for your candor and also your photos. It is a very common feeling to not be satisfied with your breasts or body in general. It is good that your fiancé tells you you don't need surgery but again it's hard to feel torn between what you want and what your partner wants. Professionally I can only tell you that you are a candidate for breast surgery, but personally it's best to pursue surgery only if you have support from your partner. Best of luck in this journey!

Hello and thank you for your excellent question. You are a great candidate for a breast augmentation.  The size, profile, shape, texture, and type of implant (e.g., saline, silicone gel, “gummy bear”) is based on your desired versus existing breast size and shape, your chest wall measurements, and soft tissue quality. Of course, you will need an in-person consultation to evaluate you for this procedure. Preoperative visualization and surgical simulation with the Crisalix system may help with your decision. I suggest that you find a board-certified plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of patients who have had similar procedures. Good luck!
Best,

Jon Ver Halen, MD FACS

Harvard educated plastic surgeon

Texas “Top Doc”