You are concerned about wrinkling, capsular contracture,
bottoming out and too fake of an appearance.
For that reason, I recommend small round textured silicone gel implants
placed retro-pectoral since they look and feel more natural, are more stable,
less likely to ripple or have complications needing revision. Implant profile is irrelevant in the
retro-pectoral position since the muscle compresses it. The advantage of the textured implant is that
is it adherent, less likely to bottom out or develop capsular contracture. The smaller the implant the more natural they
appear and at 32 AA, 200 cc implants might be the appropriate size.
Gary Horndeski, M.D.
WIthout examining you, it is impossible to give any specific advice. However, I used anatomic implants for years. When the new cohesive gel implants became available, but without an anatomic implant, I switched to them. Now that we have the anatomic implants in the cohesive gel like the Allergan 410, I have found only a few very specific reasons to use them. The regular implants do an excellent job of providing minimal wrinkling, capsular contracture and bottoming out as well as providing a very natural result.
The 410 properly placed and sized is an outstanding implant for someone who wants a low risk profile and natural result. Consult with an experienced surgeon using these devices and they can discuss the pros and cons. Cost may be similar for the time being as Allergan is offering five hundred dollars off certificates that can be obtained by your surgeon or from the Allergan website I believe.
Each implant has certain pros and cons. The standard gels are softer but may wrinkle more while the 410's are denser and more cohesive, hence the name "hyper-cohesive" or form-stable or "gummy bear" which allows them to be shaped and also makes them less resistant to deformities and, potentially, to capsular contracture as well and their potential leak rate is reported to be lower over time. But the 410 is heavier and more expensive and, because its textured, it can flip resulting in implant positional deformities. Based on your desired implant size, neither will likely make you look anything but natural or even result in bottoming out so that is really not a concern. There are also the Sientra implants which are form-stable but less expensive so that may be an option. And finally, your own body fat can be used to enhance your breast through a process call autologous fat grafting but for certain women who are petite and without a supply of fat this may be an issue. I hope this helps and have a wonderful day! Dr. Kayser - St Clair Shores, MI
He state that you want a natural look. In my experience a moderate profile plus silicone gel implant rates the most natural looking breast augmentation. There are indications for shaped breast implants but I do not think of them first when I am trying for a natural look. Please consult a plastic surgeon who is certified by the American Board of Plastic Surgery, experienced in breast surgery, and who has an excellent reputation in your community. He really need an expert surgeon to examine you and make the best recommendation for you.
Please find an experienced Board Certified Plastic Surgeon
and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all
aspects of facial surgery, breast augmentation and body procedures including
tummy tucks or mommy makeovers!
In breast augmentation I have chosen to spend time reviewing
photographs with patients to fully understand their expectation of size and
shape. Many times this simply raises
more questions. I will make measurements
and use the implant guides to allow the patient to understand exactly the sizes
that are reasonable for their body type and measurements.
Are you talking about saline vs silicone or different shaped silicone? The round moderate profile silcone implant sounds like it would probably work best, but hard to tell without an exam. Get a consult with an experienced plastic surgeon.
Consult with a Board Certified Plastic Surgeon, certified by the American Society of Plastic Surgeons (ASPS) for an exam to discuss the implants that would work best for you. An exam is needed to best answer your question.
It is hard to tell you your specific risk of rippling and wrinkling without seeing your photos or performing an in person exam. However, you are right, the 410's from Allergan, or the Mentor/Sientra equivalents, are less likely to ripple wrinkle or have capsular contraction than standard memory gel type implants. The less tissue you have, the more vulnerable you are to this. However, I have done plenty of women with almost no tissue, both sub-muscular and sub-fascial with memory gel implants with no rippling. The following link is an example of this. However, it is important to know that if the implant is placed perfectly, the implant will cause rippling if it is a 410 or memory gel, so who you choose as your surgeon is very important as well.
Pablo Prichard, MD