I'm Going from 325cc to 500 or 550cc but Can't Decide on Saline or Silicone...any Advice?

Question

I'm going in for a second augmentation for larger boobs. My PS says b/c of the way my ribcage sits that there is no way to get a lot of natural cleavage but that if I go bigger he can them a little bit closer. I'm 5'3 115lbs and want to go to 500-550cc. Do you think that will be too big on my frame? Does silicone vs. saline make that big of a difference visually? Thanks!

Craig S. Rock, MD, FACS · Answer

For the best long term results, implant dimensions should be matched to chest wall dimensions.  Although you don't provide your chest wall dimensions, based upon your height and weight, 500-550cc implants are probably too wide for your frame.  You should also consider the weight of the implants and the impact that may have on activities.  You are considering implants that weigh over 1 lb each, and that may effect your ability to run, jog, workout, etc.  Silicone implants look, feel and move more naturally than saline implants, and the difference may become even more noticeable to you as you increase implant size.  I would recommend that you discuss these issues in detail with your surgeon prior to making your decision.

	Good luck.

Miguel Delgado, MD · Answer

For your size this is a large  implant. the larger you go the more issues over time.  Doing this just for cleavage is temporary..  A bra can do wondersd with cleavage

Tom J. Pousti, MD · Answer

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" 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 press 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.

David Bogue, MD · Answer

500 or 550cc breast implants are quite large, particularly for a small frame. Often, these implants are too wide for the chest wall. Cleavage can be achieved by using very large implants, however, it very often leads to a "fake" look and can lead to issues such as synmastia (abnormal connection of the breasts across the sternum). Larger implants over time can lead to thinning of the breast tissue, scalloping or rippling being visible and palpable, and malposition as the heavy implants drop down. This can happen regardless of saline or silicone implants. Without an examination, it is impossible to tell whether these implants would be too big for your frame. I recommend seeing a few Board Certified Plastic Surgeons before making your decision.

Steven Wallach, MD · Answer

Without a full exam it is very difficult to "size you up."  I wil say that implants larger than 500 cc are pretty large and the larger the implant the more likley earlier problem will develop from the heavier weight.

I'm Going from 325cc to 500 or 550cc but Can't Decide on Saline or Silicone...any Advice?

Answers (7)

Answer: Large implants on a small frame.

Answer: Large implants on a small frame.

Answer: Implants

Answer: Implants

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Everything you need to know about Breast Implant Revision

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I'm Going from 325cc to 500 or 550cc but Can't Decide on Saline or Silicone...any Advice?

Answers (7)

Answer: Large implants on a small frame.

Answer: Large implants on a small frame.

Answer: Implants

Answer: Implants

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Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.