Kuylhee Kim, MD

Dear Caltan 

For the case of asymmetry, surgeons will sometimes pick different implants to match the patient’s two breasts more precisely. Implants have three different dimension measurements:  diameter, projection, and volume. The MOTIVA demi implant of 300cc has an 11.5cm diameter and a 3.9cm projection, while the the MOTIVA full implant of 315cc has an 11cm diameter and a 4.5cm projection. If the projection is different between your two breasts, using different profile implants can be helpful. But the surgeon also needs to assess your breast width and volume difference for precise matching. 

I hope this is helpful for you. Thank you 

Dear Skylovem 

I am so sorry to hear that you had to go through several operations and still have asymmetry. In my opinion, the reason why your right breast continues to look saggier than the left is because your breast tissue counties to fall, rather than the implant bottoming out. 

There is a similar phenomenon in unilatereal implant based breast reconstruction and contralatereal breast reduction patients. On the cancer side, after total mastectomy patient will receive a reconstruction with implant which is similar to your left side (affected by the Poland’s syndrome). This breast never get saggier because almost the volume is from the breast implant. But let’s suppose the patient undergoes a breast reduction on the non-cancer side to match the shape and volume. The reduction side will become saggier as time goes by because on this side, the volume of breast comes only from the patient’s own tissue which will eventually fall by natural causes, such as gravity. 

The difference of  implant: tissue volume ratio in breasts cause more prominent asymmetry as time goes by. To avoid this complication, some breast reconstruction surgeon will do an augmentation/reduction on the non-cancer side to produce long-lasting symmetry. In my opinion, a larger implant, lifting, and removal of some tissue on the right side will create a longer lasting symmetry for your breast. 

I hope this information is helpful. Thank you

Motiva offers two options; with or without a microchip. 

The implant with the microchip can be identified with a portable scanner after surgery. The scanner reads the unique 15-digit serial number of the individual implant. They also offer an extended warranty for the implants with a chip. The extended warranty covers revisional surgeries for implant rupture or grade 3/4 capsular contracture if they occur within 5 years after surgery.

Based on your implant card, your implant is authentic. It would have been helpful if the staff/doctors you spoke to could have given you more information about the differences between the two during consultation, other than just the price.

I hope this is helpful.  t

The Rippling phenomenon after breast augmentation is when a patient can touch or see the irregular surface of the breast implant over the skin 


Reasons why patients may have rippling complications after breast augmentation are multifaceted broken into three categories. Below are the most common in my experience:  

1. Patient factor

If the patient has a thin envelope (low BMI), there is a higher chance the patient will experience rippling after augmentation. Let's suppose an implant is covered with a thin fabric. You’re more likely to feel the creases of the implant than in the case of it being covered with a thick blanket.  In these cases, placing the implant over the muscle can cause the rippling to be more prominent. However, placing the implant under the muscle provides an additional layer of soft tissue (muscle layer) over the implant, which would provide better results.

2. Implant factor 

Some implants have a higher tendency to create folds. This typically depends on the filling rate of the implant. Filling rate is the ratio of the volume of silicone contents to the shell capacity volume. In your case,  Motiva implants have higher filling rate, so we can eliminate this factor. 

3. Surgical factor 

If the pocket (the space for the implant) is smaller than the implant dimension, the implant tends to create folding or ripples. Precise sizing of the pocket to match the size of the implant is important to avoid the rippling phenomenon. 

I recommend getting a sonographic exam to assess if there are any surgical factors. If the pocket is good, I recommend getting a fat graft to thicken the envelope. Motiva offers a warranty which covers implant rupture and grade 3/4 capsular contracture within 5 years after augmentation for patients that purchased the microchipped implants. However, even with the limited warranty for the non-chipped implants, I don’t suspect your revisional surgical work (potential fat graft) would be covered by their warranty. 

I hope this information is helpful. Thank you