Thank you for your question. A photograph would be helpful. Generally speaking if you are petite with very thin skin and do not want to look unnaturally big, a breast implant in the 250 to at most 350 cc is the most common option in my practice. From your description 400 cc seems to large. Silicon gel breast implants placed beneath the muscle would be the most likely choice. Because you have thin skin under the muscle is essential to help cover the implant. Please find a board certified plastic surgeon who has an excellent excellent reputation in your community.
Unfortunately, you have not told us your bra
size but if you are 32 or 34 each 100 cc’s of implant corresponds to 1 cup size
change. If you are 36 or 38 each 200
cc’s of implant corresponds to 1 cup size change. From this, you can compute the volume
required to achieve your desired size. I
always 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. 22% of women who undergo breast augmentation
alone require revision within 2 years because they are dissatisfied with the
result. A frequent cause of
dissatisfaction is over implantation.
400 cc to 450 cc implants are large, will extrude inferiorly and
laterally requiring revision.
Gary Horndeski, M.D.
A shaped form stable breast implant can give the patient
the lowest risk of fold and ripples in the lower pole, the lowest risk of a
visible transition between natural breast tissue and implant (sometime
refereed to as a double bubble) and the lowest risk of breast implant
malposition with the breasts bottoming out. I think there is a performance
difference between form stable breast implants. Consult with plastic surgeon
who have experience and expertise perfuming this particular procedure.
Look for many, many before and after photos on the website of the plastic surgeon you are considering to be sure there are lots of natural looking results including natural looking results in patients who are very thin with thin skin
and you must realize that implants are only designed to make you bigger and fuller. If you want the most natural look, find a local plastic surgeon who can do both the smooth round gel and textured anatomic gel to review the pros and cons of each and choose what is best for you.
Thank you for your question. I almost always recommend silicone implants, especially in patients with thin tissues. In patients with thin tissues, the characteristics of the implant are more likely to show. Saline implants are less compressible and more prone to visible rippling. Because they are less compressible, they are more likely to look very round with a possible stepoff in the upper pole where your tissue transitions onto the implant. It is not a natural look. In my practice I usually recommend a shaped implant, silicone, under the muscle in this scenario. Do not agree to an implant that is too large for your taste or your tissues. The idea is not to put in the very largest possible. I suggest you have more than one consult with Board Certified plastic surgeons before making a final decision.
Tracy Pfeifer, MD, MS
Thank you for the question.
To best help you, a physical examination or picture evaluation would be necessary in order to determine which procedure and technique would be best for your case.
Silicone implants placed under the muscle would be a better choice based upon your description. The sizing can be determined by placing sizers in the office.
Kenneth Hughes, MD
Los Angeles, CA
I think that if you want to get breast implants, you need to be seen in person to determine what is appropriate for you. Discussion of implants, shapes, sizes, incisions, and pocket location are all determined during this conversation.
With thin tissues, silicone will be a better choice, and perhaps anatomic shaped implants. They will feel and look more natural, and have less chance of rippling. They should be placed under the muscle.
Sizing is best done in person, based on trying on implant sizers, and breast measurements. If your surgeon is suggesting something larger than you want, another opinion or two will be worth you while.
All the best,
With thin skin, I recommend silicone and definitely under the muscle to reduce the risk of rippling. 400-450 cc are very large implants for your weight and I do not think they will appear natural. Your basic instincts here are correct!