"I’m 25 yo female who had breastfed for one year. I weight 135 pounds and 5’3 height and very healthy. I had laser lipo and looking to get mommy make over one by one. I want to know what size cc you recommend and the possible complications if I need a big implant. My breasts are droopy but they are DD. I just want to get them to a perky 36DDD. And to be able to wear a tshirt without a bra or a bikini. Coz now is impossible to find them. My breasts are too soft. Thanks for your advice."
DR. POUSTI: Breast Lifting and Breast Implants?.
Thank you for the question. Unfortunately, it is not possible to give you good advice without direct examination.
Whether a breast augmentation and breast lift can be done safely in one operation will depend on your physical examination and your goals. This is not a question agreed-upon by all plastic surgeons. There are good plastic surgeons who will insist on doing the procedures separately and there are good plastic surgeons who can produce excellent outcomes in a single stage.
The combination breast augmentation / mastopexy surgery differs from breast augmentation surgery alone in that it carries increased risk compared to either breast augmentation or mastopexy surgery performed separately. Furthermore, the potential need for revisionary surgery is increase with breast augmentation / mastopexy surgery done at the same time.
In my opinion, the decision to do the operation in a single or two staged fashion becomes a judgment call made by a surgeon after direct examination of the patient. For me, if I see a patient who needs a great degree of lifting, who has lost a lot of skin elasticity, or whose goal is a very large augmentation then I think it is best to do the procedures in 2 stages (in order to avoid serious complications). However, doing the procedure one stage does increase the risks of complications in general and the potential need for further surgery. This increased risk must be weighed against the practical benefits of a single stage procedure (which most patients would prefer).
Conversely, if I see a patient who requires minimal to moderate lifting along with a small to moderate size augmentation (and has good skin quality), then doing the procedure one stage is much safer. Nevertheless, the potential risks are greater with a 1 stage procedure and the patient does have a higher likelihood of needing revisionary surgery.I hope this helps.
Also, be careful about communicating your goals with specific cup size references. You may find this to be inaccurate and again a source of dissatisfaction postoperatively. 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 cup” or “fake looking” or “top heavy” 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.
I use intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient’s goals. The patient’s goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient’s goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.
Original answer submitted in the Realself community.