Tear drop or round? Replicon high projection 315ml, extra high projection 290ml, Mentor round medium plus profile 300ml? (photo)

Thanks for the photo. Obviously evaluating you in person with a full examination is optimal; however, looking at the photos it appears you may have a combination of loosening skin falling over the implant or a capsular contracture holding the implants up or an inadequate release of the implant. Addressing these issues will result in closer meeting your expectations rather than focusing only on the shape of the implants. All the best!

The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified Beverly Hills Plastic Surgeon

Thank you for the excellent description and photos. In my opinion you have more than just one thing going on. Your capsules seem to be actually holding in good position and the fullness you have in the upper pole is probably due to the high profile implant. But I still think the capsules are in a pretty good position. Your breast tissue does seem to be low. The majority of your breast mound is above the nipple with loose tissue below. One way to get more fullness at the bottom of the breast is just open your capsule and move the implants down but that may be going in the wrong direction. You might be better served by a lower profile implants which will still give you a good  shape in the upper pole and a doughnut lift to help fight gravity!

Looking closely at your photos, you can see that the implants are high, yet your breast tissue, is dropping below them. You should consider a true duel plane augmentation to allow the implants to drop and fill the “underboob”. Nevertheless, I believe you will require at least a circumareolar lift. I don’t like to recommend tear drop implants because they have texture, which although rare, has been linked to a lymphoma type cancer.

Dear kyliecurrent320ml,I use both tear drop (shaped) implants and round implants in my practice. One has to understand the dimensions of the breast to determine which implant would work best. A shaped implant looks like a tear drop and like a natural breast shape. This may sound like it makes the most sense for breast augmentation but if a patient has breast tissue already, this tends to push out or project the bottom part of the breast more so than what is natural. Two things that look like a breast don't necessarily make for a more natural looking breast. A round implant often times has a more natural look than a shaped implant because it increases the breast size more evenly. I still use shaped implants in a few circumstances when patients have no breast tissue. Patients that are very flat or have had a mastectomy. Shaped implants also have the increased risk, up to 30%, of rotation so I'm very careful when using or recommending them. The bottom line is that one should consult with a board certified plastic surgeon who does a lot of breast surgery to determine the best implant for each patient. All of my breast augmentations are designer breast augmentations which means that one size does not fit all. I customize the surgery and implant based on the characteristics of the patient and their goals.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Thank you for the question.  As you may know, simple removal/replacement of breast implants will not achieve an aesthetic outcome that you will likely be pleased with. Skillful manipulation of the surrounding breast implant capsules plus/minus breast lifting may be necessary.  Generally speaking, there are a variety of breast implants available; the variety of breast implant available raise a lot of questions from women considering breast augmentation surgery. Personally, I think that for most patients considering breast augmentation surgery, careful selection of plastic surgeon and careful communication of goals, far outweigh the specific type of breast implant utilized (when it comes to the success of the breast augmentation procedure).
Anatomical breast implants were designed to better simulate the natural breast shape; the problem with these implants is that if they shift or rotate, the entire breast will change shape as well. This change in breast shape may require further surgery to correct. Round implants, under the hand, can shift or rotate without changing the shape of the breasts. Overall, I find that beautiful outcomes can be achieved with the use of round saline or silicone gel breast implants for the vast majority of patients.
Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining 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. For example, I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. 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, after the use of temporary intraoperative sizers.
I hope this helps. Best wishes for an outcome that you will be very pleased with.