Disappointed with Breast Aug Simulation Results - what implant size and placement would give me upper pole fullness? (Photos)

Thank you for your question. Recently a published study tried to address your question, i.e., does a 3D breast augmentation simulation actually look like the real result? They basically asked multiple plastic surgeons and laypeople to look at the 3D images compared with the actual postoperative photos. In the majority of cases, the observers found that there was a "moderate" resemblance. In a small percentage of cases the 3D simulation did not resemble the actual result, and in a similar small percentage the 3D result looked very similar to the real outcome. Bottom line, no available technology will reliably simulate your exact postoperative result. Despite this fact, I still think 3D images still have some value during the consultation process. For example, they help me explain how differently-sized implants might help correct asymmetrical breasts, or how different implant profiles can affect the shape of the breasts. In my practice, 3D images are just one of many method to help my patients choose their implants. Other methods include: 1. trying on breast implant sizers, 2. looking at before-and-after photos of women with a similar breast shape, and 3. taking detailed breast measurements to ensure the patient's desired implants actually match their breast dimensions. I hope this helps!

We found that Vectra system we use in our office creates variable results when it comes to accuracy of implant size and shape selection. Usually we start with in person evaluation and a series of implant sizers after surgeon receives information about patient desire; very rarely we relay on breast 3 D simulation for breast implant augmentation. However, our results in 3 D simulation of many other procedures, in particular nose and facial surgery are very satisfactory and close to real results. In person consultation with an experienced board certified plastic surgeon should be your next step. Good luck.

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 breast 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

You appear to be a good breast augmentation candidate. Here in office, we would start by allowing you to try on a cc sizer system to see what volume you are liking. It is very important to choose an implant size that you love. From there, along with your breast measurements, we discuss profile and then see where you are aligning on cc size and profile. From your wishes, I would recommend you getting into a high-profile implant for upper pole fullness.I often see the simulations leading to disappointment, and thus do not use them in my clinic.

The implant simulator is accurate. If you simply undergo breast augmentation with your low lying breasts then you will end up with bottomed out sagging appearance breasts. You would benefit from a breast lift using 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. Later, fat transfers or small implants can be placed if additional volume is desired. Your biggest problem is not volume but position and lack of cleavage.

Best Wishes,

Gary Horndeski, M.D.