Would Like a More Rounded, Lifted Look, What Would You Suggest? (photo)

Have 225 L and 250 R Silicone Mentor Siltex Moderate Profile Now Above the Muscle.  I am 5'7", 10.7 stone, slim build. Would a larger HP implant give me a better shape or just a larger droopy boob? I attach pictures pre-op (34 B/C) and post-op (34 C/D). My surgeon says I did not need a lift as I only had mild ptosis but I am unhappy with the current shape and would like more upper pole fullness. He feels the HP would look fake and unnatural. The last picture is the kind of look i would like, but is only achievable for a short time after I have just removed my sports bra..

Doctor Answers 12

Rounder, lifted look with larger implants

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Hi there, I think you do not need a lift at this stage to achieve the look you are seeking. Larger implants with either mod plus or high profile will achieve a higher, rounder look. In Australia the 225-250cc size would be considered quite conservative : I would recommend a 375cc implant.

I would suggest nothing...

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because you have achieved a very natural, larger look from where you started from.  Examined your motivations and if truly important, then have another procedure.  But if you are 'getting by' as you are, wait on this until you need more surgery as breasts will change with time and you will need more surgery in your future.  Is it worth the costs and risks to have another one to simply make you larger?

Larger breast implants will give you more upper pole fulness.

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It does not look like you need a lift. Larger moderate PLUS profile breast implants may give you the look you want.  Also one breast is smaller and narrower, and this can be improved.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Secondary Breast Lift and Augmentation

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Patients who want a lifted look after breast augmentation may benefit from a suspension type mastopexy which can elevate the breast tissue to a higher position on the chest. The breast implants would have to be removed while the mastopexy was performed and then replaced after the mastopexy was completed. However, you could be at higher risk for inadequate blood supply to the nipples and breast tissue since you have breast implants above the muscle. You could lose your nipples or portions of breast tissue. Breast implants placed below the muscle generally preserve more of the blood supply to the breast. I think you have a very nice natural looking result and I would not recommend any surgery.

You have good results and bigger implants willl give the look you want

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The shape and size of your breast are very natural and if you want more round and tight breasts, bigger implants will help. Your plastic surgeon should be able to help you

Breast look with implants

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Your breasts look very natural. Yes one nipple is a bit lower than the other, but that is waht you started with..  A larger implant will give more fullness but no lift and depending upon the base diameter can give you more superior fullness.

Breast position on the chest is a determinant of augmentation result

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Your breast footprint appears to start relatively low on your chest. You have quite a distance from your collar bone to the 'top' of your breast. I personally do not think a breast lift would improve upper pole fullness. A larger diameter implant would, but would create a 'fake' look with a very rounded upper pole.

Would Like a More Rounded, Lifted Look, What Would You Suggest?

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As I look at the before and afters, I find myself looking at what I consider to be a nice result. 

I think what displeases you is the fact that your breasts are a bit low set on the chest wall. By the usual standards, the implants seem well positioned as regards the nipples and areolas. If you do want more upper pole fullness at a volume similar to what you have, you would probably need a breast lift with enough added scars that I am not sure the improvement would be worth it all.

It will be best to discuss in person with ;your surgeon, at which time you could look at post breast lift photos. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

More Rounded

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From your pictures it looks like you have a very nice augmentation.   You probably were right on the line of needing a lift vs not needing one.   Trying the augmentation first and then doing a lift if needed in the future in not an uncommon way to take care of someone like yourself.   A larger or higher profile silicone implant will really just make your current look larger.   You may have a bit of a lift temporarily, but they will fall like the current ones have.   A lift may be your best option.   Another option would be saline implants as we can overfill them and give you more cleavage and more round appearance at the same time you do your lift.   The silicone implants are a very nice and natural looking an feeling implant so to remove them for saline is not what I typically recommend, but it may be an option in your case.   Again, you have a nice/expected result.   I would address your concerns with your surgeon and see what he/she thinks.   Best of luck to you.

Answer from Dr. Costanzo Thousand Oaks, California

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I would suggest you get bigger implants, stay on top the muscle, but raise the implants by tightening the inferior capsule that surrounds the implant.  This should work for you.


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.