I'm having trouble making a final decision on implants. We are definitely using Mentor Silicone. I'm pretty certain I want the high profile and considering 425-450cc. I am 5'7" 125 lbs. Thin, slightly muscular frame. PS measured my BWD as 12-12.5. I was a full C before breastfeeding, and now I'm a deflated, sagging B. Looking to be a full C/ small D. I will be receiving vertical mastopexy along with implants. Does this seem to be an appropriate implant choice to achieve my goals?
5'7" 125lbs. Considering 450cc Mentor Silicone HP Implants. Recommendations?
Doctor Answers 9
DO NOT LET YOUR SURGEON PICK YOUR DESIRED SIZE.
This has been interesting reading for me as I am a plastic surgeon who specializes in BA. I perform about 450 such procedures annually. Let me tell you what I have learned. The best way to choose your implant is to forget about cc’s. Let the surgeon do that…it’s his job. What you should do is be able to communicate the look you are trying to achieve and often pictures of other people is a good place to start. There have been many times when a patient has told me they wanted to be a full c and then I see pictures depicting a d cup. It’s not exact but a good place to start. Take a look at the surgeon’s before and after pictures to se if there are sizes which you find appealing. The measurements which we take are guidelines for some of the decisions which we make. They are not exact criteria for the size you should get and neither are the implant dimensions. There are certainly people who have chosen implants smaller than what their chest could accommodate and the corollary has occurred very often, as well. DO NOT LET YOUR SURGEON PICK YOUR DESIRED SIZE. We are not the ones living with it. Unless there is a definite anatomic restriction it may be the time to get another opinion.
Now a few words about implants. Saline are still the most common in the U.S. but are they the best choice? Not in my humble opinion. I believe them to have too much rippling upon palpation. The only positive aspect is that they require a much smaller incision for placement. As for silicone, I find them to feel the most natural. Silicone implants are much different than the ones which were taken off the market in the early 90′s. The shells are much thicker and the silicone gel is much thicker (cohesive). Cohesive is a term for all silicone and is confusing because there are varying degrees of cohesiveness. The old implants were cohesive but in such a state that they would leak. The new implants (cohesive I) will not leak but if cut in half and squeezed it will not return to the original shape. Cohesive II (Mentor Lumera) are much thicker such that they have a jello appearance when cut and will return to their original form after being squeezed. These are available only in textured and tear drop shape. They offer a bit less rippling than the cohesive I but are also a bit firmer and I believe less of an option for purely cosmetic reasons. The last is cohesive III (gummie bear) which are the thickest. I have not had as much experience with these but am a little discouraged by the feel (too firm) and the incision required (long and inframmamary position). The cohesive II and III are much less pliable and require a larger incision as they are not pliable and have memory of form. My last point…there is never a reason to put an implant above the muscle (subglandular) position. It is a setup for problems. It appalls me that some surgeons still do it that way.
Not crazy about high profile implants.
There are 3 profiles available from the 2 major implant manufacturers in the U.S. I have used all 3 and find that the high profile implants don't look as natural (more globular) than the other 2. This is a matter of personal opinion. Discuss the pro's and con's of implant profile and size with your surgeon.
Choosing Breast Implant Size?
Thank you for the question.
Have a full discussion and communication regarding your desired goals with your plastic surgeon. This if communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
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” etc means different things to different people and therefore prove unhelpful. Also, as discussed above, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery.
I hope this helps.
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Implant Selection Process
In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics. Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.
Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
The next step is to try on this range of implants in the office with your doctor. The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant. It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
I wish you a safe recovery and fantastic result.
Choosing the right breast implant
From what you are describing the 450cc mentor hi profile gel may be about right for you along with the lift if needed. Mentor does have a sizer bra system that may assist in your decision if your surgeon has one. Of cours, a physical exam and understanding with your plastic surgeon can go a long way to making certain that you are happy.
Without an exam in person, it is difficult to say whether or not the implant you chose is the right one for you. I like to add a vertical left when necessary as well.
Choosing the right size implant
It is impossible make recommendations without photos or an examination. Based on your description I suspect that 450cc will get you into a D cup.
Breast implant size
Implant size selection
Your choice of a HP implant seems reasonable. I would also suggest you try silicone gel sizers as well. I help my patients select the correct size with two methods:
1. Dimensional planning and
2. A Gel Implant Sizing system
Dimensional planning – The measurements of your chest wall are taken. Also, the breast dimensions including the height, width, and current dimensions of each breast form the basis of dimensional planning. Based on these measurements, the implant size is recommended. This will give you a unique breast implant that is suited for your body frame. Even your fitness levels and other relevant criteria are taken into consideration. It is you who will decide what you are comfortable with.
Gel Implant Sizing system – During the preliminary breast implant consultation, you will be provided with an option to “try on” a variety of implant shapes and sizes. You can also visualize the possible outcomes of your surgery which helps you to get that perfect size to give you the shape that you longed for.
This way your preferences are known and you can then pick a range of implants that will “fit” just right to give a soft natural fuller look.
Hope this is helpful.
Best of luck!
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.