5'8 Figure Competitor Going from 360 Cc Saline to 550-600cc Silicone

Figure competotors have a unique set of issues with implants. Because body fat is low, coverage of the implants is less so rippling is more apparent. Muscle coverage helps the upper portion of the breast but can result in paroblems such as animation deformities. All of these issues may be more severe with larger implants. Options to consider are conversion to a split muscle technique, and a Strattice internal bra for support and coverage with larger implants. Implant profile type will depend on the desired volume and the base diameter of the breasts.

Converting to silicone breast implants is a good option to reduce the incidence of rippling.   However since your body fat percentage is probably quite low, switching to a large silicone implant (550-600cc) may still be problematic for you. That size implant could still result in rippling. I would recommend you discuss this issue further with your plastic surgeon before undergoing surgery.

You could consider increasing your implant size by 100 cc or so, but I would still be worried about rippling with large implants in a female bodybuilder or figure competitor.

Best wishes,

Dr. Bruno

50  cc will make an almost imperceptible difference in your final breast size.  50 cc is equal to about 3 tablespoons.  If you placed a 600 cc implant in 1 breast and a 550 in another, you would have to look very closely at your final results to notice the difference. 

Much of the final “look” achieved after breast augmentationrevisionary 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 breast 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.

Studies have demonstrated that for the patient to notice a significant increase in size, the implant should be increased by 150-200cc in volume. I would also point out that my own impression is that silicone implants, cc for cc, appear slightly smaller than saline implants. Finally, in my own patients looking for a significant increase in size, most were happier when the larger option was chosen.  That being said, my opinion without seeing your photos or physical examination, would be to go to the larger size.

Bumpin you up to a 550 or 600 cc implants is a significant change from where you are now.  The rippling is a factor of having thin osft tissue coverage over your implant.  Depending upon where the rippling is, can be corrected with submuscular implants or alloderm palcement.

Hi Phoenix6787,

A few things:

1)  It makes a lot of sense for you to go from saline implants to silicone gel, since they (silicone gel) are much less likely to ripple.  They can ripple, but do not typically do so as much as saline implants do.  The less of your own tissue you have (skin, fat and breast tissue) the more visible any implant will be.  Body builders, runners, people who exercise a lot for any reason, people with low body fat - all of these people are going to benefit that much more from silicone gel.  So that's a good move.

2) Increase in size.  You have to make sure that you have enough tissue to cover your desired increase in size.  There are no absolute rules on that but remember that the larger the implant (of any type) the more it will look like an implant.  You can express your desire as to what size you want and then discuss it with your surgeon.  Not every size is possible in every patient.  The doctor will probably try to accommodate your wishes so the best thing is to not entrench yourself on a specific size.  By all means express your wishes and desires, but try to be open about it.

3)  It's about 30 cc to one ounce,  and the average shot glass in the United States is about 45 cc, or one and a half ounces.  That means that the different between a 550 and a 600 cc implant is basically negligible.  Most likely, if your surgeon put the implants in blindly (don't worry, won't happen!) neither you nor he/she would ever be able to tell if they were 550s or 600s.  So I wouldn't worry too much about that.

In sum, switching to silicone implants makes a lot of sense, I wouldn't be overly concerned about the difference between a 550 and a 660 and, finally, be sure to tell your surgeon what you think you'd like, and then go with what he/she suggests.  And there are, of course, no guarantees with any surgical procedure, and no "correct" answers when it comes to aesthetic issues.

I hope that this helps, and good luck,

Dr. E