Motiva round full or moderate implants? I need advice for my size. (Photos)

Question

I’m 43 years old, 154 cm tall, with a waist of 70 cm and hips 100 cm. My breast base width is approximately 13 cm. I have most of my natural breast tissue in the lower part of the breast, and I have an hourglass figure. I’ve been recommended Motiva Round Full 375cc, as I lack volume mostly in the upper pole. My biggest concern is that the projection might be too high, and I’ll end up with “porn-style” breasts — where the implant looks like a small ball in a large sock. I don’t want saggy breasts, but I’m worried that high-profile implants will look too narrow and stick out too much. However, my surgeon says this profile would suit me well because I naturally have more tissue in the lower part of the breast. What do you think? Is this implant and projection appropriate for my anatomy and aesthetic goals?

Sibel Atalay, MD · Answer

I hear you, it’s very natural to feel unsure when it comes to projection and profile, especially since the words “high profile” can sound more dramatic than the actual result often looks. The good thing is that you already have a clear picture of what you want: restoring upper pole fullness, keeping your hourglass proportions, and avoiding a round, artificial look.
With a breast base width of ~13 cm, the implant choice is partly dictated by proportions. A 375cc Motiva Round Full is designed to give fullness where you’re lacking (the upper pole), but still blend with your natural breast shape. Because you already carry more tissue in the lower pole, a higher profile implant often helps balance that by filling out the top, otherwise, a lower profile can sometimes spread too wide and exaggerate that “bottom-heavy” look.
The “ball in a sock” effect you’re worried about usually happens when the implant is too narrow for the chest or when skin/tissue doesn’t support the implant well. In your case, the 13 cm base width allows for an implant that actually matches your frame, and Motiva’s design tends to create a softer slope rather than the sharp “stuck-on” look. The higher projection will add youthful fullness without necessarily making the breast look fake, especially since you already have natural tissue to soften the contour.
So, in short: the recommendation makes sense for your anatomy and your goals. If you’re still hesitant, you could ask to try sizers in the office with a fitted shirt, often, seeing the difference between moderate-plus and high projection on your own body helps a lot more than comparing numbers. But from what you’ve described, 375cc Round Full sounds like a very appropriate balance for restoring your shape while keeping things elegant and proportional.

Gary M. Horndeski, MD · Answer

Your breast are low on the chest wall. You will need a circumareola approach to reposition the nipple-areola complexes higher and more medial. At size 32 or 34, each 100 cc of implant corresponds to 1 cup size change. At size 36 or 38, each 200 cc of implant corresponds to 1 cup size change. From this, you can determine the volume required to achieve your desired goal.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Dana Goldberg, MD · Answer

I agree with your surgeon in this situation. The porn star look comes from an implant that is much larger than the base width of the breast and generally occurs in patient with little to no breast tissue to cover the implant. I think the higher profile will help give more of a perceived lift and could still look extremely natural. Best wishes for a great result!!

Daniel Barrett, MD · Answer

Dear nshe003,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Donovan Rosas, MD · Answer

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and your surgeon create your custom surgical plan. 
With regards to your particular question, the question of profile is primary when selecting an implant. The decision is made with respect to breast width. As discussed above, the goal is to avoid exceeding the width. A higher profile implant will deliver a greater volume in a smaller width. If you are not seeking a significant upsize, a moderate profile is a reasonable option.
As always, discuss your concerns with a board certified plastic surgeon.

Emre Guvercin, MD, FEBOPRAS · Answer

Thank you for sharing such a well-considered question &mdash; your attention to proportion, shape, and projection is exactly what leads to the best outcomes.From your description:
You have an hourglass figure with a 13 cm breast base,Most of your natural breast tissue is in the lower pole, andYour main goal is to restore upper pole fullness without going into an unnatural or exaggerated projection.Let’s break it down:1. Concerns with high-projection implants are validYou’re absolutely right to be cautious &mdash; Full or high-profile implants on a relatively narrow base (13 cm) can sometimes:Look narrow and round ("ball-on-chest" effect),Sit too far forward,Or create the appearance of "implants wearing the breast," especially when placed over lower-heavy natural tissue.2. A better match: Motiva Mini or Demi profileIn your case, a Motiva Round Mini or Demi profile would:Respect your natural breast base,Provide more natural horizontal width,Still give you upper pole fullness, but in a gentle slope rather than a sharp, artificial curve.3. Technique matters as much as implantTo achieve your desired result, I often use the Préserve Technique &mdash; a highly selective, anatomical augmentation that:Focuses volume toward the upper pole, where you need it most,Leaves lower pole tissue untouched and supported,Provides a natural shape that flows with your body &mdash; not against itThis approach works particularly well in patients like you who already have adequate lower pole tissue and want a refined, elegant enhancement &mdash; not an exaggerated one.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Tuan A Truong, MD, FACS · Answer

Thank you for your question. Final breast appearance and implant sizing and profile is a complex interplay between patient desires, tissue quality and tissue quantity. As you are undoubtedly aware, an in-depth conversation and consultation with a board-certified plastic surgeon will help you narrow down these choices and ease the fear of an undesirable outcome. Good luck on your journey!

Camille Cash, MD · Answer

Many surgeons have sample implants available that you can "try on" to get an idea of how you may look after surgery.  This can guide you in not only volume selection, but profile as well.  In addition I like to use sizers during surgery to help my patients achieve the look they are wanting.  I've included a video I hope you find helpful.

Motiva round full or moderate implants? I need advice for my size. (Photos)

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