Breast implants on larger breast?

Question

Hello. Ive always wondered about this. In 2010 I had a reduction and went from a 34G to a 34D. Over time I've put on some weight and my and I've come back around to a 38H. I have a lot of under boob but its sooo flat up top. I know when I drop about 40lbs (curently at 180lbs) they will look deflated. Am I able to get implants while my natural breast are an H cup?

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Donovan Rosas, MD · Answer

The simple answer to your question is...yes. Larger breasted individuals are candidates for augmentation.
Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and your surgeon create your custom surgical plan. 
As always, discuss your concerns with a board certified plastic surgeon.

Sacha Obaid, MD · Answer

Hello!  It is difficult to answer your question without an in person evaluation.  If you have a lot of excess skin, you may need another breast lift.  I would recommend consulting with a board certified plastic surgeon to discuss your concerns.  Best of luck to you!

Leila Kasrai, MD, FRCSC · Answer

It may be possible however sagging is a common side effect related to weight fluctuations. Therefore, a lift may be recommended with your implants.

Daniel Barrett, MD · Answer

Dear Johmjohm69,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Joshua T Halka, MD · Answer

This is a common problem seen after breast reductions, while the vast majority of patients are happy, many wish they had more upper breast fullness and consider implants. It is more common than you think and something I have done quite often.
Many of the patients like yourself have had a breast reduction years ago and their breasts have continued to change and they are looking for some improvement in their shape. Often these patients get great results because their breasts already have a good shape. Hope this helps!

Garey Simmonds, MD · Answer

In general you are able to get breast implants on larger breasts. Since you have had a previous reduction your pre operative evaluation would include an assessment of your previous surgical incisions to assess the vascularity of your breast to make sure implantation could be done safely

Connie Hiers, MD, FACS · Answer

Yes, you can get implants placed behind the muscle for better upper breast fullness. If your total size with implants is too large, more lower breast tissue can be removed at the same time.

Camille Cash, MD · Answer

Yes, you are still able to get breast implants even if you have larger natural breasts.  If you are wanting to add more upper pole fullness without adding more volume you may be a candidate for autoaugmentation.  This uses your own tissue to give upper pole fullness.  This is different from fat grafting.  I've included a video that I hope you find helpful.