Athletic, 31 yr old, 34A, 5'5, 120 lb, 12 cm b-width, LEO wants to be small D cup, but go back to weight lifting (5 days/wk for 13 yrs), insanity/plyo, etc. I don't want my implant look to change much after surgery (don't want softball look). Also still want kids & to breast feed. I've had multi consults...some say under some over (after I press that I want to weight lift again), all docs say silicone but they mention HP, Mod +, or form stable "gummy" (will it shift?). All say incision under crease.So I had my last 2 consults this week (after I posted above).The final 2 doctors I'm deciding on have 2 dif opinions. Help!Dr 1 originally (1 1/2 yrs ago) thought I might be good candidate for the form stable (shaped textured implant) but since he didn't know much about yet said to wait on surgery. Today went back & 1st thing he stated was he didn't like the new implants (stated has ONLY used them for reconstruction) & proceeded to recommend Mod+ no larger than 280cc, under the muscle (again I only have 12 cm width).but then when I reminded him of how I want to go back to lifting weights & being very active he then said New Form Stable OVER the muscle no more than 300cc....this suprised me because one other doc said 450cc!Dr 2 - he is one of top 10 leading researchers/users of the new form stable (style 410) in the US.He also said 12 cm & states even with my workout regime he said HP, under muscle 275-400cc max but after I looked at computer images (attached) 375cc looked good to me.however I also got to see computer image of Mod+ (style 15?) & Mod+ implant seemed a bit more perky with not as long of a slope, but he still recommends the HP.i don't want torpedo boob!soooooo confused! Help!
Answer: Confused breast augmentation patient It is okay to get to varying opinions about a particular procedure. When you start to have multiple consults and multiple multiples with the same person you get to much information that can lead to considerable confusion. I would suggest a couple things one you might consider waiting to have a breast augmentation after you have your family. Number two you have to trust the surgeon that you feel most comfortable with and rely on his or her judgment. Good luck.Earl Stephenson, JR, M.D., DDS, FACS
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Answer: Confused breast augmentation patient It is okay to get to varying opinions about a particular procedure. When you start to have multiple consults and multiple multiples with the same person you get to much information that can lead to considerable confusion. I would suggest a couple things one you might consider waiting to have a breast augmentation after you have your family. Number two you have to trust the surgeon that you feel most comfortable with and rely on his or her judgment. Good luck.Earl Stephenson, JR, M.D., DDS, FACS
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April 3, 2014
Answer: Implant volume and cup size At size 34 A each 100 cc’s of implant corresponds to 1 cup size change. 300 cc implants would take you to a D. I always recommend small round textured silicone gel implants placed retro-pectoral since they look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it. Since you are very active, I recommend the smallest implant possible, which will have less displacement with muscle contracture.Best Wishes,Gary Horndeski, M.D.
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April 3, 2014
Answer: Implant volume and cup size At size 34 A each 100 cc’s of implant corresponds to 1 cup size change. 300 cc implants would take you to a D. I always recommend small round textured silicone gel implants placed retro-pectoral since they look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it. Since you are very active, I recommend the smallest implant possible, which will have less displacement with muscle contracture.Best Wishes,Gary Horndeski, M.D.
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March 18, 2014
Answer: Confused About Breast Implant Selection You certainly have done your homework, and considered your options. The descriptive paragraph you provided is very helpful. You have experienced firsthand that each surgeon may provide different recommendations based on practice philosophy, their individual patient experiences, and beliefs/biases regarding implant styles and types. Implant selection can be a complicated process, and requires a complete patient examination and detailed consultation to reach that decision. Therefore, in many respects, the surgeons that have already examined you in detail are in a much better position to provide recommendations then anything someone else can tell you over the Internet. In addition to base width, skin elasticity and breast skin envelope compliance are also important in the implant selection process. You do have a good starting shape, and so with a moderate augmentation, you should get a very nice result. I agree that a silicone gel implant would be your best option. With your continued desire to be very physically active, a subglandular implant position may be better, but this location does have a higher risk for capsular contracture. The Natrelle 410 would complement your preoperative shape very well. However, if you're going to continue to be extremely physically active, it would probably be best not to utilize this implant in a subpectoral position since there is likely increased stress placed on the shell as a result of the textured surface and its integration into the breast capsule. I prefer subpectoral implant placement (greater tissue coverage, lower risk of capsular contracture, less rippling, improved mammography) and an inframammary approach (ability to make a longer incision, control of the inframammary fold, good exposure, reusable) because of the benefits they offer. The simulation photograph you included certainly shows a nice result using a 375cc high-profile (style 20) round gel. You mentioned that you don't want your breasts to have a "softball look" or be "torpedo boobs". A high profile implant is more spherical in shape, and out of all the implants, is most likely to give this type of look. I believe high-profile implants also direct greater biomechanical stress on the breast anteriorly and inferiorly. In patients with less skin elasticity, this stress can lead to stretching of the inferior pole skin (over time), and additional implant descent, producing a high riding nipple-areolar complex. For these reasons, you may wish to consider a moderate profile (style 15) implant instead. This may mean that you have to settle on a slightly lower volume, but in the long run may achieve a better result. There will be advantages and disadvantages to every decision regarding pocket location, fill material, implant style, and implant size. Ultimately you should settle with the surgeon that you believe understands your needs the best, and (the one you trust) will give you the results that you desire. I hope this was helpful. Best wishes.
Helpful 1 person found this helpful
March 18, 2014
Answer: Confused About Breast Implant Selection You certainly have done your homework, and considered your options. The descriptive paragraph you provided is very helpful. You have experienced firsthand that each surgeon may provide different recommendations based on practice philosophy, their individual patient experiences, and beliefs/biases regarding implant styles and types. Implant selection can be a complicated process, and requires a complete patient examination and detailed consultation to reach that decision. Therefore, in many respects, the surgeons that have already examined you in detail are in a much better position to provide recommendations then anything someone else can tell you over the Internet. In addition to base width, skin elasticity and breast skin envelope compliance are also important in the implant selection process. You do have a good starting shape, and so with a moderate augmentation, you should get a very nice result. I agree that a silicone gel implant would be your best option. With your continued desire to be very physically active, a subglandular implant position may be better, but this location does have a higher risk for capsular contracture. The Natrelle 410 would complement your preoperative shape very well. However, if you're going to continue to be extremely physically active, it would probably be best not to utilize this implant in a subpectoral position since there is likely increased stress placed on the shell as a result of the textured surface and its integration into the breast capsule. I prefer subpectoral implant placement (greater tissue coverage, lower risk of capsular contracture, less rippling, improved mammography) and an inframammary approach (ability to make a longer incision, control of the inframammary fold, good exposure, reusable) because of the benefits they offer. The simulation photograph you included certainly shows a nice result using a 375cc high-profile (style 20) round gel. You mentioned that you don't want your breasts to have a "softball look" or be "torpedo boobs". A high profile implant is more spherical in shape, and out of all the implants, is most likely to give this type of look. I believe high-profile implants also direct greater biomechanical stress on the breast anteriorly and inferiorly. In patients with less skin elasticity, this stress can lead to stretching of the inferior pole skin (over time), and additional implant descent, producing a high riding nipple-areolar complex. For these reasons, you may wish to consider a moderate profile (style 15) implant instead. This may mean that you have to settle on a slightly lower volume, but in the long run may achieve a better result. There will be advantages and disadvantages to every decision regarding pocket location, fill material, implant style, and implant size. Ultimately you should settle with the surgeon that you believe understands your needs the best, and (the one you trust) will give you the results that you desire. I hope this was helpful. Best wishes.
Helpful 1 person found this helpful
March 18, 2014
Answer: Confused Way too many moving parts here, you need to pick the doctor and tell him or her what you want in your own words, it seems you are being moved around. With your anatomy and desire to workout I would likely do 270 under the muscle
Helpful 1 person found this helpful
March 18, 2014
Answer: Confused Way too many moving parts here, you need to pick the doctor and tell him or her what you want in your own words, it seems you are being moved around. With your anatomy and desire to workout I would likely do 270 under the muscle
Helpful 1 person found this helpful
Answer: BBA There is no way to guarantee a particular bra size. Bra sizing varies greatly between bra manufacturers and a C in one bra will be a D in another. What matters more than the assigned bra size is the way the implant looks on you. The best option for your body and aesthetic goals can be determined in a thorough implant sizing session.Implant sizing depends on several factors. One of the most important factors is your breast width. Generally, your surgeon will measure your breast width, and then provide you with a range of implant sizes appropriate for your native breast size. There are more nuances to it than just what I've described, but this approach works for most women.I usually have my patients bring in a large bra and a tight t-shirt to do sizing. I'll then choose 3-4 implants that I feel are appropriate, and have my patients place them in the bra under the tight t-shirt. My patients can then look in the mirror and get a good sense of what they will look like with the provided implant sizes. My patients like this approach and get a great idea of how they will look.By using this technique, your surgeon can outline a range of appropriate implant sizes that will be aesthetically pleasing, and you make the final decision.I hope this helps. Good luck!
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Answer: BBA There is no way to guarantee a particular bra size. Bra sizing varies greatly between bra manufacturers and a C in one bra will be a D in another. What matters more than the assigned bra size is the way the implant looks on you. The best option for your body and aesthetic goals can be determined in a thorough implant sizing session.Implant sizing depends on several factors. One of the most important factors is your breast width. Generally, your surgeon will measure your breast width, and then provide you with a range of implant sizes appropriate for your native breast size. There are more nuances to it than just what I've described, but this approach works for most women.I usually have my patients bring in a large bra and a tight t-shirt to do sizing. I'll then choose 3-4 implants that I feel are appropriate, and have my patients place them in the bra under the tight t-shirt. My patients can then look in the mirror and get a good sense of what they will look like with the provided implant sizes. My patients like this approach and get a great idea of how they will look.By using this technique, your surgeon can outline a range of appropriate implant sizes that will be aesthetically pleasing, and you make the final decision.I hope this helps. Good luck!
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