Would I get a natural result with 290cc under muscle round silicone implants and would they sit far apart? (Photo)

Thank you for your pictures and questions. I think that based on the photo, you are a good candidate for breast augmentation surgery. As for volume, you should try on implants in your surgeon's office to determine if 290 cc gives you the volume you are looking for. If so, then your surgeon can choose an implant in that range that fits your frame. I would say that in patients that are petite such as yourself, a round implant gives a very rounded appearance and a rounded upper pole of the breast, which I would not consider to be "natural." Not to say that this look is bad, it is just not natural. So you need to ask yourself if you want a rounded full upper pole of your breast, or you really would rather have a more natural result. If you are more interested in a natural sloping upper pole, you may want to discuss with your surgeon the use of teardrop form stable implants. As for the distance between the implants, your anatomy defines that, not the implant. If you have a wide sternum with outward pointing nipples, that result will not change, and might even be made more prominent with placement of implants and that is something you need to expect and accept before proceeding with surgery.Hope this helps!

Good questions. Given your anatomy and your relatively wide spaced nipples,
I would highly recommend you have silicone implants placed over the muscle and
not under it. This way you can have better cleavage and of course avoid the
movement artifact that comes with implants under the muscle.

It is very difficult to determine the best lift you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implants

Hello,Go visit a few ABPS certified/ASAPS member surgeons that specialize in breast surgery. Tissue based measurements will determine the most appropriate sized implant for you based on your body's anatomic capacity. This will give you a very natural result.  Best of luck!

I appreciate your question.



The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

Silicone will give you a fullness at the top (upper pole fullness).



Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.



Anatomic gummy bear implants might be a good choice to give you volume.



These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.



During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.





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 breast surgery.





Best of luck!





Dr. Schwartz



Board Certified Plastic Surgeon



#RealSelf100Surgeon



#RealSelfCORESurgeon

so I would suggest you focus on what look you would like to have.  Whatever you choose, with your nipples pointing outwards, they will will do that and with smaller implants of smaller diameters, you're going to either have a wide gap between the mounds or nipples that point even more outwards.  So the largest implant you can live will will help with your final results.  Let your surgeon show you how wide the implant is going to be and how much space is anticipated from your choice.

If you have a wider implant, you will improve cleavage. A 290 cc implant is likely narrower than your breast width. As a result, it will have little impact on your cleavage (it just won't reach). Thus, when surgeons talk about base width, it matters because it helps reshape the breast from the frontal view to better match your shape. Too small can look just as fake as "too big." 
You should see a board-certified plastic surgeon in your area to get a formal opinion through an in-person consultation.

Many patients have either a wide nipple-areolar spacing, or an outward 'tilt' to the nipple-areolar complex. One mistake to avoid is in using smaller volume (narrower) implants, and positioning them closer to accentuate the cleavage definition. This only serves to drive the nipple position further outward. The implant size should be appropriate for your chest width, and centered on your natural breast position. This can only be determined in an in-person consultation. With the appropriate size and placement, you should be able to attain a very natural aesthetic result following breast augmentation. Best of luck.

Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.  Some general thoughts regarding "cleavage concerns" may be helpful to you and other young ladies considering breast surgery:





Patients undergoing breast augmentation should understand that their anatomical “starting point” will play a significant "role" in the outcome that they can expect with breast augmentation surgery.   If the patient starts out with a significant distance between the breasts, there are limits as to how close of "cleavage" can be achieved.  If over dissection (when developing breast implant pocket) occurs in the cleavage area, with the goal being to achieve as close as possible cleavage per patient's request, patients may experience significant problems such as breast implant displacement (medial  malposition or symmastia) and/or significant breast implant rippling/palpability.  Obviously, these types of problems may require revisionary breast surgery to correct.  











Also, keep in mind, that each nipple/areola complex must remain centered on each breast mound after surgery.  Again, careful dissection of the breast implant pocket and appropriate selection of breast implant size/width/profile will also play a role when it comes to how close the cleavage area will be postoperatively (and the overall shape/symmetry of the breasts). Careful measurement/dimensional planning plays a big role in this regard.





Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.







 Generally speaking, the best online advice I can give to ladies who are considering breast augmentation 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. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining 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. For example, I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.



Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.



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, after the use of temporary intraoperative sizers.







I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with. 

Thank you for the photo and the question and what I tell patients is the cleavage you have is the cleavage you have.  Your breasts are naturally far apart and will be following surgery though they will look closer together though your actual distance between the breasts will not have changed.  Attempting to move the implants closer to the midline will make your nipples point further out and may lead to symmastia.Dr. Corbin