My wife is going to get Breast Augmentation in 3 months. She's 130 lbs, 5'4", 34A (breast fed 2 children), breast width was narrow, long torso and curvy hips, measured 1" on the upper pec/armpit area. We have decided on Silicone Breast Implants and under the muscle. She wants to be a small/medium C. One doctor said 350cc smooth high profile round implants. Our fear is we don't like the grapefruit look under the skin. We want a natural slope and decent cleavage. What are your thoughts? Which implant (high profile, mod+, mod) and what size would you recommend? Attached picture with measurements.
Which Breast Implants Result in Natural Slope and Cleavage?
Doctor Answers (12)
Natural looking breast augmentation
The actual size of a breast implant, measured in cc's, is really not very descriptive of what a breast augmentation will look like, or what the cup size will be. It is all relative to the size of the breast and the size of the patient preoperatively. A tall, broad-shouldered patient with small A-cup breasts may require 450cc implants to achieve a C-cup breast volume postoperatively, while a shorter patient with medium B-cup breasts may only need a 250cc implant to achieve a C-cup breast volume.
If a natural appearance is the goal, then the way to get the size right is to 'try out' different implant volumes and profiles in the operating room. Once the implant pockets have been created, sterile sizers can be placed in the implant pockets, and the upper half of the O.R. table raised so that the resulting breast appearance can be assessed with the patient in an upright 'sitting' position (chest fully upright) while under anesthesia. These sizers are available not only for each implant size but also for each implant profile: low, moderate and high (in this practice we use high-profile implants only in rare instances). Inflatable sizers are used for saline implant augmentations, and pre-filled gel sizers are used for gel implant augmentations.
Thanks for all the info. I prefer High profile implants for most patients that want to be a little bigger but are fairly narrow. Moderate plus are all right as well, they can give a bit more cleavage with less projection at the same volume of the HP's.
Natural look in breast augmentation.
1) Take a look at the breast augmentation page on my web site. It deals with all of your concerns.
2) 350 cc's is probably too big to avoid the grapefruit look on your wife's body.
3) A natural look is not achieved by the shape of the implant. It is achieved by using the right size (determined with disposable implant SIZERS during surgery) and by good surgical technique.
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Best breast implants for natural shape
There are several factors to consider. In general, silicone will feel and behave more like a natural breast. Then next step is to select the size, and the most common way to do this is trying on samples in a bra with the desired cup. Once the implant size is decided, then the implant with the best match of diameter to the base diameter of the breast is determined. That is how the cleavage will be optimized. In general, a high profile implant is to maximize volume on a narrow base, low profile to minimize size on a wide base. High profile implants have a steeper angle from the upper chest into the breast so they tend to have less of a slope.
Choosing the right implant look
Based on your wife's photo, bra size, weight and height a 350-400cc moderate plus silicone implant would be my highest suggestion. Reason is, a high profile implant is selected more for petite women with a 30-32 bra size. High profile implants have a small base & project forward, giving the more "done" vs "real" look. Moderate profile implants have a wider base and much lees of a projection meant for a 34+ bra size. Moderate plus is basically in the middle, for a 32-34 bra size, projection is more realistic but still with some perk.
Breast implants for natural results
The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size or breast "look".
This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone and low/moderate/high profile), bra manufacturer variance in cup sizes, the degree of filling of the cup with breast tissue, and the subjective differences in patients perceptions of cup size.
Much of the final “look” achieved after breast augmentation surgery depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone) or model (low/moderate/high profile) of implant.
3. The type of implant used may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have. If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants. If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result. On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference. Patients may need an MRI to diagnose a silicone gel rupture. Saline implants are also less expensive than the silicone gel implants. Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants. On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational. As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may make a significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon. 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.
The natural looking breast implant.
I offer patient's a simple analogy to illustrate what we mean:
Q: If you take a baseball and you cover it with a silksheet, what will it look like?
A: Like a baseball, you will even see the stitching.
Q: Now if you take that same baseball and cover it with a comforter what will you see?
A: It depends on how thick the comforter is but generally you will see a softly shaped lump.
So now the question is what do you have on your chest, silk sheets or comforters?
The way we determine this is by looking at your chest, if I can see your ribs (under the muscle) then you anatomy will have a hard time disguising the implant whether it is placed under or over the muscle and you are more likely better off with a silicone implant. Another way of measuring this is to pinch your upper chest skin (similar to pinch and inch of your waist on the Special K commercial). If you have less than an 2 cm (under 4/5 of an inch) than you have "silk sheets"
If you have a thicker skin/fat/breast layer that pinches over an inch than you have the option of going under or over.
Now the exception to the rule:
Q: What happens if you change the baseball to a volleyball?
A: All bets are off, whether you put it under or over the muscle it will not look natural.
The last issue is the implant shape. A moderate or moderate plus implant that has minimal projection is more likely to be more natural appearing (less baseball like). However many paitents seek upper pole fullness and larger volumes with a small BWD and the only way to achieve this is with a high profile implant. There are some anatomic shaped implants but I have generally found them to produce no significant difference in outcome with the exception of breast cancer reconstruction. However, this is my personal opinion
Moderate or low profile breast implants give a more natural breast look than high profile
Your concerns are valid. High profile breast implants can look unnatural and do not move and adjust to the natural breast profile as readily as lower profile breast implants.
The most common implant I use is the moderate profile plus silicone gel implant, which gives a more natural yet full shape to the breast after breast augmentation.
Natural Results With Breast Implants
Without question silicone implants will provide more natural results when compared to saline implants. A high profile implant can be very helpful in achieving more natural results in a woman with narrow breasts who desire a notable enhancement. The high profile implant is narrower than the other style of implants and this may certainly be appropriate for your wife's anatomy.
Most important to a nice, natural result is taking into consideration your wife's breast and chest anatomy. Careful assessment of not only the measurements of the breast/chest, but also the amount and nature of the breast tissue present, the quality of the breast skin and any existing asymmetries is critical to achieving a natural result. These assessments will guide your surgeon to match the appropriate size and style of implant to achieve your wife's aesthetic goals.
Congratulations on your decision and best of luck!
Web reference: http://www.drlouisdeluca.com/
Natural results with high profile implants
The style, size and type of implant selected will vary from patient to patient. Depending on how much natural breast tissue you have a natural looking result can be obtained with a high profile implant. It depends on the volume of enhancement you want as well.
In looking at the same base width of an implant, the high profile implant will have more volume and therefore more projection.
I'd recommend a sizing appointment with your wife's plastic surgeon to actually try on the implants to see what the options are. I wish you well.
Web reference: http://www.medwardsmd.com/plasticsurgery_questions1.html
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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