Is saline a better option based on my size? I'd like to balance out my larger hips but not bottom out- 425 ccs? (photo)

I'm 5'9" 118lbs. I want a slightly larger than natural look as Id like to balance out my childbearing hips! I am worried about the safety of silicone but I'm afraid being so thin saline would look unnatural. Can someone my size have a BA and not look like melons are sitting on my chest?! I thought I wanted around 350cc but now think that to correct my droopy boobs I'll need 400-450

Doctor Answers 18

Saline vs Silicone Gel Implants

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Based on your height a volume in the 400-450 cc range is possible. A saline implant of this volume can feel heavy and may be a burden to you over time, however it is possible if placed in a submuscular pocket. However, in someone thin like yourself, even in a submuscular pocket, saline may not fell as natural to the touch and may not feel as natural from an athletic activity perspective. The " melon " shape can result from either type of implant placed on top of the muscle ( as opposed to submuscular)  especially when you have very little of your tissue covering it. Shaped ( as opposed to round ) implants have become an interesting option for a more gentle slope from chest wall to implant and deserve some consideration after hearing the pros and cons. Come to your consultation with an open mind, Vectra Imaging and external sizers can be very helpful in determining the volume that is right for you.

Breast implant size and type

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I appreciate your question.
The size of implant is dictated by your chest measurements.
The type depends on what you want to achieve.
Silicone will give you a fullness at the top and can be slightly unnatural based on your body fat.
Anatomic gummy bear implants might be a good choice to give you volume.

The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

best of luck!

Dr Schwartz


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With your small frame you should aim to go for the most natural looking and feeling - hands down silicone. You are so petite that I would encourage you to stay below 400 closer to 350.  Implants have been demonstrated safe and approved by the FDA but you need to live with them.  Educate yourself about the difference between saline and silicone and take your time making an informed decision.  

Implant type

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Cohesive silicone implants have been tested and approved by the FDA.  They have many advantages over saline including less rippling in thin patients, longer lifespan, more natural feel.

John L. Burns Jr., MD
Dallas Plastic Surgeon
4.7 out of 5 stars 56 reviews

Breast augmentation candidate, some advices:

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Thank you very much for this interesting question.

In my practice i recommend using - Cohesive Gel - Silicón Breast Implants with textured cover.
They are quite safe and aesthetically best as they give a firmer consistency, better projection and most natural appearance than Saline implants. 

Kind regards,
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 367 reviews

Saline implants

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To me, silicone gel implants are the Mercedes of implants and saline implants are the Honda of implants.  They will both get you where you want to go.  It's just a matter of style.  Silicone gel implants more closely approximate the look and feel of real breast tissue.  Saline implants are basically a bag full of water and they have the potential to look or feel like a bag full of water.  Ripples and wrinkles are less noticeable with silicone gel implants than with saline implants.  My final thought with regards to implants is that silicone gel was removed from the market for fourteen years and extensively studied.  At the end of that time, they were approved by the FDA and returned to the market.  I think they are excellent implants with a proven safety record.  If you are nervous about silicone gel, however, then get saline implants.  Life is too short to worry about your implants.  Based on your pictures, you do not appear to need a breast lift procedure.  Finally, questions regarding what volume to use are best answered in consultation with a board-certified plastic surgeon who can examine you in person and review your options with you.

Edwin C. Pound, III, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 26 reviews


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It looks like you've lost  a little volume, but still have a natural shape. I would bet that the smaller size will fill out the loose breast skin adequately, but a proper assessment will require an in person consultation. In general, the silicone implants are more likely to feel natural, and in the case of ripples, the gels may also look more natural since rippling is less common.

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

I want my breast augmentation to be natural

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The safety profile of both saline and silicone implants are similar enough they don't generally impact my recommendations. In larger implants, saline can have a slightly less natural look than silicone, but in the 400+ range, you will still have upper pole fullness that many consider 'less natural.' 

I would recommend a formal discussion to identify your goals more precisely, have an exam performed, and then allow an individualized recommendation be made.

Good luck!

Bryan Correa, MD
Houston Plastic Surgeon

Is saline a better option?

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Thank you for your questions and photographs.  Implant size selection is an exciting part of the breast augmentation process, but also stressful because of the number of choices that need to be made.  Without an in-person examination that permits measurement of key breast parameters, and a thorough discussion as to your goal appearance it is difficult to recommend a particular style, size, or profile of implant.   In your case I would favor silicone implants, as they weigh less than saline, causing less stress to your skin, look more natural, and are trending towards fewer complications.  Hope that this helps.

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 80 reviews

Is saline a better option based on my size? I'd like to balance out my larger hips but not bottom out- 425 ccs?

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Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.  Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical.  

Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant type/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 know words such as “natural” or "C or D cup” or "balance out" 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 (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

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.