Bilaterial Mastecomy Patients; What Type of Implant Will Provide the Best Projection, Most Natural Look, No Rippling?

I'm 5'7", 140lbs, before cancer breast were 36DD, Reconstruction surgery date 8/8/13. Tissue expander@ 550CC. met with doctor today & I requested for Allergan Nitrel 410, he has never used before but willing. Per my Kaiser DR., he tried to order FX size but was told only for doctors who have been in the study can order Extreme projection. Is that true? What type of implant will provide the largest projection, most natural look anatomic with no rippling.

Doctor Answers 6

Best Implants for Breast Reconstruction

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Thank you for your question.   I would recommend the FF series of the 410's.  This will offer the best projection in this shaped implant.  If you desire more projection, you may benefit from fat grafting to build the mound. 

I wish you a safe recovery and amazing result.

Dr. Gill

Houston Plastic Surgeon
4.8 out of 5 stars 94 reviews

Breast reconstruction

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Yes it is true that the FX is not available.  The devices were released with limited options to provide the providers with limited experience the ability to care for patients with shaped devices but not make inappropriate decisions based on a lack of experience with the devices.  

Shaped implant options for breast reconstruction

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It is true that Allergan has only made a portion of the form-stable shaped implants (style 410) available, but Sientra has a wider range of styles available in the U.S. so that may be an option worth looking into. You may need more expansion however to get to the total volume you want.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 reviews

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Implants in reconstruction are limited by your expansion

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and your doctor should have access to many shaped implants (textured, anatomic cohesive gel) with something that should fit your footprint and volume.  There are several manufacturers of such implants and it would require your doctor having access to them in order to consider using them.  With your expansion, the largest implant you could have would be around 525 cc's.  Is that large enough for you?  Do not even consider saline implants as they ripple excessively in reconstruction.  Finally, if your doctor is unable to get what you want, is there any other surgeon in that system who can?  And if so, consider changing surgeons.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Implant reconstruction and projection

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There are limitations on how much projection that can be achieved because of the limitations in the implants that are available in the US.  If you are opting for silicone gel implants, I would suggestion you explore the Allergan Style 45 implants or the 410 implants.   Even with the highest projected implant, your surgeon may not be able to achieve your goals with implants alone.  You may need to consider autologous reconstruction.  Please talk to your surgeon about your concerns.  He/she is the best perform to answer your question.


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The Allergan 410 offers a more cohesive silicone therefore a firmer implant. Possibly less rippling and more upper pole fill. The largest implant in the full height/full projection is 740cc so this is your maximum size however it may not fit your chest wall so getting the correct style and size is critical. These implants are available now to all plastic surgeons if they go on line and complete a training module.

Glenn Lyle, MD
Raleigh-Durham Plastic Surgeon

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.