Mentor 405cc moderate plus extra under the muscle. Will larger implants increase upper fullness? (photos)

Most women cannot take 450 or 500 cc on the chest without going to a high profile implant. There is a good chance that a breast lift may be needed to lift the areola depending upon the final position of the implants.

Good morning,
You do have a little bottoming out, which means your implants mainly sit below your nipple level, which makes your nipple position look high and takes away from your cleavage and upper pole fullness. Simply going bigger will not correct this- you need the pockets fixed. I correct this with the Original Internal Bra, my strong permanent internal suturing technique, which corrects your bottoming out, moves your implants higher on your chest wall and closer together, and secures them there over the long term. I first developed this technique 20 years ago, and today it is the most common revision I perform, 5-6 times a week- it works and it lasts!

Implants that are too big, too high profile, or too firm (from overfill, very highly cohesive gel, or scar capsule tightness) have a greater impact on tissue stretch, leading to, as in your case, drop out. If you want more upper pole fullness, you should consider an alternative to the overfilled device from Mentor. An implant that is flatter, wider, and less overfilled (with a more cohesive gel than found in Mentor) will give you more reliable upper pole fullness and be less likely to drop out. I have no financial relationship with any implant company in the US ( I do with Motiva, a company that does not have implants here), but I think that the implant that serves most women best is made by Sientra. There devices are slightly underfilled, but with highly cohesive gel - actually there is a choice of two levels of cohesivity - and their shells are more elastic. Together, this adds up to a device that is softer than a comparable Natrelle Inspira implant, and one that is more reliable in shape than a traditional (non-overfilled) Mentor implant. I only recommend going bigger if you want to be bigger; don't do it to only achieve a shape change.

Dear Intellectual338385,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I believe that the short answer to your question as to whether larger implants are the answer is 'no'. You are already, by the photos, in a over-dissected situation, with stretching of the lower breast skin. Larger implants will temporarily give you superior fullness, it is true, but the price will be lose of this fullness over time with further stretching of the lower pole skin. Take your pre photos and seek the opinions of experienced surgeons before making a decision. Best of luck,
Leland Deane MD FACS

An examination is required to make the correct surgical plan. Having said that, it appears that your implants have moved lower on your chest. A larger implant will make this issue worse. The lower part of you breast needs better support. This is usually done with sutures and often an support implant like Galaflex or Allograph. Good luck

Thanks for the question and very nice complete photos.
It seems your breasts were originally low on your chest wall and then your lower breast skin stretched from the weight of your 405cc implants. The Mentor 405cc moderate plus X implant has decent projection with a narrower base width. Increasing the size may give you temporary upper pole fullness, but the potential for more stretching and bottom breast fullness is a real issue. Youi should either leave them alone, or look into a High profile X or Ultra high profile implant of the same size.
Dr. T

Your results are good. Part of your concern relates to where God put your breasts, just a little lower on your chest than you prefer. Having said that, an exchange to a larger implant with release of your upper breast scar (capsulotomy) without release lower down along with a more cohesive implant can get you closer to your desired shape.

Remember that the enemy of good enough is better. You risk infection, contracture, loss of the implant, etc.

Good luck

Thank you for the question an photos and it would appear that a larger implant would give you the desired result. So get your records and preop photos and go on some consultations with experts and compare recommendations after a full examination and discussion of desired results

Dr Corbin

I use exclusively Mentor and in the gels, the 405 is a moderate profile. So you could get more upper pole fullness but probably need HP. Be careful though as you could have complications that, while rare, could ruin a nice result.