Ellis Choy

Hi there,
Thank you for your question and photos regarding your situation.
Yes. You'll be a suitable candidate for consideration of a combined breast implant lift with a reduction approach. 
As a result of weight loss, your breasts appear to be quite deflated and droopy in addition to your moderate degree of breast asymmetry. The redundant saggy breast tissues will need to be removed for equalising the native breast volume between the two sides before appropriate pockets (either in front or behind your pectoralis muscle) to be created for allowing the implants to fill the deflated breast volume. This is followed by the appropriate tightening of the overlying breast envelope and lifting/reshaping of your nipple areolar complex to restore the balance & harmony of your breast shape & form. Depending on your situation and the type & level of cover from private health insurance, you may qualify for a partial rebate for the breast reduction component of the surgery provided there is evidence that it is performed for medical reasons. Your breast implant component however will be purely cosmetic with nil cover as the implants are used to optimise the aesthetic shape of the final outcome of your breast enhancement surgery.
I highly recommend you to seek an in person consultation with a specialist plastic surgeon for a proper clinical assessment to find out the most suitable options for you surgically, logistically and financially.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Very sorry to learn about your situation. Unfortunately capsular contracture is one of the known complications in breast implant surgery but it's less common to occur at only 1 year post operative time frame. There are different degree of severity ranging from the capsule being palpable, visible or even painful. Like in your situation, it can cause a multitude of functional and cosmetic issues.
It can be difficult to predict the natural course or progression of capsular contracture. in addition to clinical assessment, sometimes it may warrant a radiological assessment, either with ultrasound or MRI, mainly to assess the integrity of implants as well as the quality of breast parenchyma. In view of recent change of breast symptoms after your recent breast implant surgery, it is always wise to exclude the rare possibility of any unrecognised breast condition despite capsular contracture is the likely diagnosis based on your recent medical assessment. Radiological imaging could also provide some objective evidence of your condition as well as additional information to assist the preoperative planning of your breast implant revision surgery in time ahead.
Hope that helps. 
Best wishes 
Ellis Choy

Hi there,
Thank you for your photos and questions.
Don't freak out! Your breasts are NOT tuberous at all! Tuberous breasts are specific constricted breast base anomalies characterised by a constellation of features such as tubular "pointy" breast shape, varying degree of breast hypoplasia (underdevelopment) especially in lower poles, enlarged or even herniated nipple areolar complex etc.
In short, I think you're a great candidate for primary breast augmentation with potential excellent surgical outcome. It'll be wise to seek a formal consultation with a specialist plastic surgeon for further in depth clinical assessment.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Yes. You do have a slight degree of breast asymmetry which is within normal limit. Both your nipple positions otherwise appear quite favourable and I think a larger implant on your left side (the smaller side) may potentially improve the minor asymmetry as described.
Choice of implants are always to  be guided by your consultation with your surgeon and your personal desires & preference for the ideal surgical outcome. There are a number of factors for consideration and it's difficult to advise without an in person consultation with proper clinical assessment. 
In addition to varying approaches in deciding the most appropriate implants with my patients during consultation, I always use an intra-operative gel sizer implant during the surgery in determining the most suitable choice of implants on the operating table. This will also help in working out whether using a different sized implants between the two sides is a worthwhile approach in achieving optimal shape, size and symmetry.
Good luck with your upcoming surgery. 
Best wishes
Ellis Choy

Hi there,
Yes. You are a great candidate for primary breast augmentation with likely excellent surgical outcome. 
Based on your supplied photo, I personally won't be too concerned about your relative minor breast asymmetry to warrant two different sized implants. Depending on the degree of augmentation you'll be having, sometimes the asymmetry may become "less obvious" since the overall breast volume is significantly increased and the absolute volume difference between the two breasts will be less. 
However, I'll be hesitant to call any elective, cosmetic and invasive procedure straight forward without a proper in person clinical consultation. It's always wise not to trivialise any surgery especially when there are a multitude of potential complications that could occur. Your ultimate desires and expectations are also important considerations in having the right surgeon to achieve the right outcome for you.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Thank you for your question and photo.
Yes. I agree that you do have a mild degree of breast asymmetry with slightly less volume on your left side with slightly lower nipple position.
However it's difficult to judge based on photo alone without an in person consultation. Assuming the size discrepancy is real, different sized implants may help improve the size asymmetry. It'll be best to discuss your concerns with your surgeon during the consultation.
Hope that helps.
Best wishes
Ellis Choy

Hi there, 
Thank you for your question.
Unfortunately it'll be difficult to give any proper advice without any clinical photos. 
In general, it all depends on your desires and expectations for your ideal surgical outcome. Sometimes for "borderline" cases where the nipples still sit in reasonable positions with reference to the breast fold, it may still be possible to "get away" with a lift provided there is appropriate choice of implants and surgical technique. However, it'll have limited effect in elevating the "footprint" of your breasts on your chest wall. It also depends on your pre-existing breast volume as well as tissue quality. 
In short, I'll recommend you to seek a proper advice from a specialist plastic surgeon for a detailed clinical assessment.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Thank you for your question.
There is no reasons why you can't consider the possibility of getting breast implant surgery even though you've got type I diabetes. It's all about managing the peri-operative risks associated in general anaesthetics as well as taking appropriate precautions against any potential wound healing issues. Diabetic patients do have higher risks of wound related complications as well as less resistance to infection. It is therefore important to seek proper advice from a specialist plastic surgeon for a detailed clinical assessment before making any surgical plans. It will also be wise to seek an opinion from your endocrinologist to assess your individual clinical risks from your diabetic point of view.
In my practice, I have close liaison with my patients' endocrinologist in operating on all my diabetic plastic surgery patients. Breast implant surgery is an elective, cosmetic and invasive procedure. There are risks just like any other surgeries, and it's all about balancing all the associated risks & benefits before making the right decision for yourself.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Tuberous breasts are complex developmental constricted breast base anomalies with varying degree of severity. There are a wide range of surgical approach and techniques with both cosmetic & reconstructive implications. Patients' desires & expectations, surgeon's experience & preferences are also important consideration in the overall surgical management plan.
Without seeing any photos, it's difficult to comment any further about your particular situation. It'll be best for you to seek a in person consultation with a specialist plastic surgeon who specialises in both reconstructive and cosmetic breast surgery. 
For further assistance, feel free to submit an enquiry to my practice via PSF for more information.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
I'm sorry to learn about how you feel about yourself due to various post pregnancy body changes despite the recent birth of your third and final beautiful child!
I believe you are far from being a lost cause, and there are in fact many of my patients who share similar struggles in similar situations like yours. I think you'll be an excellent candidate for consideration of a Mummy Makeover with appropriate body contouring surgery for both your breasts and abdomen. However, this is not a minor undertaking and you'll need to be realistic in your desires and expectations of what you endeavour to achieve through surgery. Timings and commitments are also important considerations in balancing various competing priorities in your busy family life right now.
I would recommend you to visit a specialist plastic surgeon for a in person consultation regarding your situation before determining the appropriate next step of action. 
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Thank you for sharing your photos and stories in your search so far in your breast augmentation journey.
In short I think you'll be an excellent candidate for a great result regardless of the choice of implants whether tear drop or round shaped. You appear to be most suitable for a dual plane approach with modest size (350g to 400g) but high profile round implants to "fill" the relatively deflated breast envelope. That should comfortably achieve your desired surgical outcome of a fuller perkier look from a deflated B cup to a good D cup result. Should you desire a "bigger" proportional outcome with implants more than 400g, I'll be inclined to recommend tear drop shaped implants which will give you a more preferential fill and lift in the lower pole of the breasts without compromising the natural looking surgical result.
Hope that address your concerns and queries. For further in depth assistance or a Skype consult, feel free to submit an enquiry to my practice via PSF for more information.
Best wishes
Ellis Choy

Hi there,
Really sorry to learn about your difficult circumstances. 
In short, you will benefit from a revisional breast lift with an anchor scar pattern to improve your situation. This will improve both the tissue excess in the lower pole as well as lifting the nipples to more favourable positions while enhancing the overall breast shape & symmetry.
It'll be important for you to communicate your dissatisfaction to your original surgeon before making further plans for your revision surgery.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Thank you for your question and photos.
I think you'll have a great natural full looking result with breast augmentation alone without lift.
I would personally recommend a dual plane approach with a high profile anatomical shaped implant to both fill and lift the deflated breast skin envelope while maintaining a natural full looking result.
Obviously it'll be best to seek an in person consultation with a specialist plastic surgeon for further clinical assessment. Feel free to submit an enquiry to my practice via PSF if I can be of any further assistance.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Thank you for your question and sharing your story and photos.
Based on your photos, it does appear that you have both nipple and glandular ptosis, i.e. both your breasts and nipple positions seem to lie below the level of your breast folds. In my opinion you'll be best suited for a combined breast implant lift procedure to achieve an optimal aesthetic surgical outcome.
Choice of implants and surgical technique are really governed by various factors, such as your breast tissue quality, degree of tightening & lifting of your breast skin envelope, as well as your desires and expectations. A natural surgical result is also influenced by attending to the proportion between your breasts & your body frame in restoring the overall harmony in an elegant way. 
Breast implants alone in some selected circumstances may "get away" with an acceptable outcome in borderline cases, however it may involve lowering the fold a bit to accommodate a "larger size" implants to fill the volume void from the deflated breasts. This obviously will also need to take into consideration of your desired surgical outcome in this particular context.
Unfortunately it's difficult to give further accurate advice without seeing you in person. Feel free to submit an enquiry to my practice via PSF if I can be of further assistance.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Thank you for your question.
Without seeing any pictures, it's difficult to comment or advice whether your puffy nipples are within "normal limits" or whether there are some underlying traits of tuberous breasts involving areolar herniation giving the appearance of an enlarged, puffy or even herniated nipple areolar complex.
Either way, an areolar reshaping procedure can be considered for solving your problem pending on the severity of your condition and your expectation of the surgical outcome.
Feel free to submit an enquiry to my practice via PSF for further information if I can be of further assistance.
Hope that helps.
Best wishes
Ellis Choy

Hi Lillian,
Thank you for your question and photos.
Based on your description and photos, I think breast augmentation alone will achieve a very natural looking result without associated lift procedure. However it's important for you to appreciate some minor asymmetry that you have with your left breast being slightly more ptotic in comparison to the right.
A dual plane with anatomical (tear drop shaped) implant approach will help fill and lift your breasts in achieving a very natural looking result in your particular situation. Feel free to submit an enquiry to my practice via PSF if I can be of any further assistance.
Hope that helps.
Best wishes
Ellis Choy

Hi Shellie,
I think you are a great candidate for a combined breast implant lift procedure given the degree of breast ptosis & deflation from your supplied photo.
While a lollipop scar approach with a high profile implant is possible in your situation, the ultimate decision for the appropriate surgical technique will be based on your desired surgical outcome, your breast tissue quality, as well as your surgeon's preference.
I highly recommend you to seek a proper in person consultation with a specialist plastic surgeon for further advice regarding your situation. Feel free to submit an enquiry to my practice via PSF if I can be of further assistance.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Thank you for your question and photos.
Yes, you're likely to have a good surgical outcome with breast augmentation alone. I don't think a lift procedure is indicated in your situation as your nipple positions appear to be quite favourable with reference to your breast fold despite the significant deflation subsequent to your previous pregnancies.
It'll be best however for you to discuss your options with a specialist plastic surgeon for further details. A thorough clinical assessment is necessary before deciding on any relevant surgical plans. 
Hope that helps.
Best wishes
Ellis Choy

Hi there,
I think it's important to clarify what tuberous breasts mean before addressing your particular concerns. 
Tuberous breast deformity generally refers to a developmental form of constricted breast base anomaly characterised by a "tubular" shaped breasts associated with different degree of breast deficiency, high riding infra-mammary folds and enlarged or even "herniated" nipple areolar complex. It has varying degree of severity and could sometimes contribute to certain degree of breast asymmetry when it affects the two breasts in a different way.
Based on the above descriptions, I would be hesitant to "label" you with such condition. However you do have moderate degree of breast ptosis and asymmetry and without knowing your clinical background (?age, ?previous pregnancies, ?weight loss etc), it's difficult to judge whether this is an acquired consequence due to a variety of environmental factors and social circumstances. 
I think a breast implant lift procedure will help improve the shape, size and symmetry in your particular situation. Details regarding logistics and recovery can only be guided by an informed consultation with a plastic surgeon of your choice. As there are multiple factors involved depending on numerous possible settings, it's important to find a plastic surgeon who understands your concerns & appreciates your desires before formulating plans for the actual surgical procedure. 
Hope that helps.
Best wishes
Ellis Choy

Hi there,
I don't think you need a lift at all provided you appreciate you do have a moderate degree of breast asymmetry to start off with. 
No two breasts are the same, they are "sisters" but not "twins"! Less is more, and I would personally recommend doing "less" with a straight breast augmentation without lift with possibility of using different implants to help improve the minor asymmetry that you have. Of course it'll also depend on your desires and expectations, however I do think this is a more prudent advice as you are not committing any scars on your breast mound unnecessarily especially with both your nipples in very favourable positions above your breast folds. Obviously you'll still need to be prepared for possibility of either a lift or a nipple reshaping procedure down the track if that's not enough. Most likely, I suspect you'll be very happy with the degree of improvement after the surgery and most of all, you still have options for further enhancement in perfecting the ideal surgical result!
In terms of technical consideration, it really depends on your preferred style and surgical outcome. Assuming you have decent amount of tissue coverage in the upper pole, I believe you'll have very good results with either round or tear drop implants, in front or behind the muscles. Best option would be to discuss your situation with a plastic surgeon whom you feel would be able to achieve a result that is right for you and have the trust that he or she will advise in your best interest! 
Hope that helps!
Best wishes
Ellis Choy 

Hi there,
Congratulations on your decision in your upcoming breast augmentation sometime this year!
Judging from the photos you supplied and your desired surgical outcome for your particular body shape and active lifestyle, I personally favour tear drop/anatomical shaped implants with a dual plane pocket placement in achieving a natural looking proportional results in your scenario. 
In addition to the aesthetic reasons mentioned above, the firmer "cohesive" consistency in tear drop silicone implants allows better shape retention especially when it comes to your potential pregnancy plan and the dual plane pocket technique have less interference with the breast tissue plane dissection in limiting interference with your breast feeding ability. 
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Downsizing implants can be a "tricky" procedure to perform without the associated tightening and lifting of the pre-stretched breast tissue envelope. There are a multitude of breast factors, patient factors and surgeon factors for consideration before determining the most appropriate technique in achieving the optimal result. 
In essence, it is a form of revisional breast implant surgery and it's important to ascertain the reasons for a downsize. Whether it's for a functional problem (in relation to capsular contracture, implant leak/rupture etc), an aesthetic deformity (implant malposition, breast animation deformity etc), unexpected life circumstances such as significant weight fluctuations, pregnancy effects etc., or even simply a change in life style or personal preferences, defining the purpose and goals for the surgery is fundamental before deciding for the actual implant options and the associated surgical approach. Realistic patient expectations & desires are the beginning of a successful & beautiful surgical journey. 
Without seeing you in person or having any clinical information concerning your previous breast implant surgery, it'll be very difficult to offer you the most suitable surgical solution. I highly recommend you to return to your original surgeon for further in depth advise. Or else please submit a personal enquiry to my practice via PSF and my team can arrange a Skype consult for further discussion accordingly.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
You're right in saying that polyurethane implants can be more difficult to remove due to its extra adhesive "sticky" nature as it's primarily used for more stable implant positioning in the short term and "proposed" lower rate of capsular contracture in the long term.
In terms of what your breasts will look like after your revision will depend on what they look like now and the reasons why you are not overly happy with them after your initial surgery back in April this year. Your desires and expectations are always important in determining how your projected surgical outcome is to be achieved. It'll be best to return to your original surgeon and discuss your particular concerns before rushing into any premature decisions for further operation.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Congratulations on your upcoming Wedding! Congratulations also on your breast enhancement procedure so far! 
It generally takes around 6 weeks post op for the final shape & size to eventuate after any form of breast implant procedure. I usually advise my patients to start bra shopping at that time frame in order to get the most appropriate sizing from a more long term perspective. 
Wedding dress could be a bit different as it relates to the particular style and look that you would like to achieve on your very special day! That's why for my bridal patients, I recommend surgery ideally to be completed at least 6-9 months before the actual Wedding day in order to allow enough time for suitable fitting for the Wedding dress. Similar to your breast surgery, you like your Wedding to be PREFECT! It seems that you probably had quite a significant enlargement with reference to your height & weight, you may want to get an opinion early from your taylor regarding possibility of likely alteration of your Wedding dress! 
Hope that helps.
Best wishes 
Ellis Choy

Hi there,
In general, I would advise avoiding heavy lifting or any upper limb exercise that involves flexing the pec major muscle for at least 6 weeks after a breast augmentation procedure. Depending on surgical technique, especially with sub pectoral or dual plane pocket (behind the muscle) for implant placement, it may take even longer before resuming any form of full on muscle activity.
It would be wise to seek some form of modified duties at work during the post op period in order to allow conservative provision for your most optimal recovery. Sometimes it can also be difficult to predict on how well you are going to recover from the surgery, it is always nice to have that extra peace of mind in your lead up of preparation for the upcoming surgery. Of course it'll be best to double check your concerns with your surgeon before making any appropriate logistical arrangements.
Hope that helps.
Best wishes 
Ellis Choy

Hi there,
Breast augmentation alone for tuberous breast correction can be difficult to judge based purely on photos supplied. I don't think any surgeon will be prepared to "guarantee" an ideal surgical outcome without a proper clinical assessment. While your desire for the projected surgical result seems to be a reasonable expectation, the associated tradeoffs & limitations in different techniques can be hard to evaluate without knowing the degree of your breast tissue quality & laxity.
However, it does appear there is good possibility that you could still achieve a very elegant natural looking result provided you appreciate all potential tradeoffs especially with regards to less favourable nipple positions vs risk of double breast contour in the lower pole should your breast fold needs to be lowered to accommodate a decent size implant to "fill" the breast pocket. 
I would really recommend you to have a proper consultation with a Specialist Plastic Surgeon in person before making any definitive decision for your breast enhancement procedure.
Hope that helps.
Best wishes
Ellis Choy

Hi Tash,
I think it really depends on your goals for the surgical enhancement or correction of your breast asymmetry condition. There will always be tradeoffs between different approach in addressing your specific clinical situation.
Breast asymmetry correction can be very complex and is more than just volume equalisation. Without knowing exactly what you really want to achieve with respect to size, shape & symmetry, it can be difficult to advise what would be the right thing to do in your case. 
If you really value an independent qualified opinion, I highly recommend you to have a personal consultation with a specialist plastic surgeon for learning more about the various suitable options available. You only have one chance to create your "perfect" breasts!
This is purely elective surgery. I sincerely think it'll worth you while to consider all your options before committing to a decision which is right for you.
Hope that helps.
Best wishes
Ellis Choy

Hi there,
I think you do have some mild degree of tuberous breast condition as characterised by the apparent "tubular" breast shape, deficiency in the lower breast poles, areolar "spreading" +/- herniation (hard to assess based on photos alone) and high riding infra-mammary folds. There are multiple factors which could influence your ability to breast feed and it'll unlikely be due to your tuberous condition alone.
Options for surgical correction could range widely depending on your desires and expectations of the ultimate aesthetic outcome that is right from you. They invariably involve surgical management of your nipple-areolar complex, reshaping & lifting of your breast tissue with or without volume adjustment, as well as tightening of the skin envelope in achieving a natural aesthetically pleasing result. I suspect a bilateral augmentation mastopexy (breast implants & lift) with a lollipop scar approach would provide an elegant enhancement while restoring your overall breast harmony & proportion.
In the absence of significant breast asymmetry, it can be difficult to assess whether you qualify for potential rebate from Medicare. It'll be best for you to seek a proper consultation in person with a specialist plastic surgeon to assess your situation from both clinical & logistical point of view. 
Hope that helps.
Best wishes
Ellis Choy

Hi there,
Congratulations on your upcoming breast augmentation surgery! 
Using an implant under your native breast width is unlikely to widen your naturally nice and close cleavage gap as you put it. With appropriate pre-operative planning in achieving a subtle, yet elegant natural enhancement, the addition of the breast implants will only accentuate your already gifted cleavage lines. Your choice for the implant size can certainly influence the perception of your cleavage, but I don't think it'll widen your cleavage provided the appropriate relevant surgical technique is executed. 
I personally think you're going to have a fantastic outcome especially with your desires & expectations described. It is natural to have concerns leading to any kind of surgery. Hope this will put your mind at ease a bit in your preparation for your big day!
Best wishes
Ellis Choy

Hi Cathy,
Sorry to learn about your dissatisfaction with the surgical outcome thus far. It can be difficult to advise appropriately in these circumstances about the right thing to do without a proper clinical assessment. 
Breast augmentation revision is a complex cosmetic procedure to get right especially with consideration of the original problems or underlying reasons for the revision in the first place. It is invariably influenced by the patient's expectations of the desired surgical outcome and the surgeon's preference of the ideal surgical technique in achieving the ultimate aesthetically pleasing surgical result.
You're correct in saying that the polyurethane implants tend to "stick" more and do not drop. However, they also tend to soften over time while the immediate post op swelling subsides during the early healing phase. Overall, it's important to understand and appreciate that the healing will likely take longer than usual, especially in comparison to your original breast implant surgery. I generally advise my patients that it takes at least 6 to 12 months for all healing & scarring, both internal & external, to fully mature. While things may not seem to be in the "right direction" in your situation right now, I think it would be wise to allow more time for things to settle and eventuate while maintaining close communication with your surgeon along the process. I also think it is a bit premature now to consider lifting the nipples to higher positions without allowing sufficient opportunity for the situation to declare itself appropriately.
Good luck with your ongoing recovery, and I sincerely hope that things will improve in due course. 
Best wishes
Ellis Choy