Is It Possible to Order Customized Breast Implants?

Question

I had breast implant revision surgery recently to replace saline implants which visibly wrinkled. I have very little breast tissue and therefore chose the Mentor CPG "gummy bear" implant. These implants even looked more wrinkled from the thicker folds of the shell.The surgeon replaced them 3 days later with an overfilled saline implant. I now have 2 very firm, but not wrinkled, balls on my chest.

	I am 48. I am 5'6", 118 pounds. According to my surgeon, I have the least breast tissue of everyone he has ever seen. I went from an athletic 32AA to a 34 DDD and I feel way out of proportion. He had to keep filling the shell with saline until there were no visible wrinkles. I was wondering if it is possible to order a custom, more solid gummy bear implant that does not fold when held vertically?

	Thank you.

Richard Baxter, MD · Answer

You have received good advice in the previous answers. The problem is related as much to the size of the implants and the effects of this on stretching your tissues as to the implant type. It is likely that you will need to consider something like alloderm grafts and perhaps downsizing a bit. Since I wrote the original article on alloderm for this purpose, it is a special area of interest and I would be happy to discuss it with you.

Michael S. Beckenstein, MD · Answer

You sound like you have a petite frame and placed implants way too big, stretching out your tissue and enabling rippling. I would not recommend any device that size. You can remove the devices, let the tissue contract and place smaller, more appropriate devices, or change to smaller ones with a lift.

Steven H. Williams, MD · Answer

Thanks for your question -
Implants can be camouflaged by placing them under the muscle, placing products like alloderm over them within the pocket, etc.
However, it sounds like the fundamental problem is you have gone from very small to very large which has noticeably thinned your tissue.
The first decision you need to consider is if you really want to stay this size.  If you do it will be challenging to mask the implants.
There are custom silicone implants that are available but they wouldn't be a great choice in your situation because they tend to be more firm than traditional implants.
I hope this helps.

Kris M. Reddy, MD, FACS · Answer

Sorry to hear about your negative experience. The breast implant companies will not custom make breast implants for the American market. As your question suggests, you understand the limitations that conventional breast implants have limitations especially for those with thin tissue.

Steven Wallach, MD · Answer

The United States breast implant companies will not make custom implants anymore.  The wrinkles on the skin develop from the implants because of  the visibility through thin tissues.

Peter E. Johnson, MD · Answer

Julie,
We enjoy the Allergan saline and silicone gel implants in augmentation, especially in a submuscular position for individuals with thin breast tissue.
We also have a large practice in breast reconstruction and have used very many of the Allergan 410 cohesive gel implants in reconstruction and have had a very good experience with them. Patients for reconstruction have the thinnest tissue of all and it can be difficult to hide the implant well. The 410 is a shaped implant with an upper taper, come in "custom" sizes and have the least wrinkle or show while maintaining reasonable softness.
Our Canadian colleges use many in augmentation and seem to like them. 
You can contact Allergan and see if a practice is using the 410 in your area. This may be the best way to keep your full augmentation comfortable and pretty.
Best of luck,
peterejohnsonmd

Kenneth R. Francis, MD, FACS · Answer

Julie,
I don't quite understand the need for DDD saline implants.  You don't say whether your implants are under or over the muscle.  If they are over the muscle the rippling is much more visible.  If this is the case, then your implants can be changed to an under the muscle position to improve the rippling.  If they are already under the muscle, you may have smaller saline implants placed and overfilled instead of your present DDDs.  Good luck!

David A. Dreyfuss, MD · Answer

Custom breast implants are available, but would be of little benefit. They are made of the same material as regular implants. Your size is an issue and your surgeon did not make the correct choice for you. You need a submuscular, smooth wall silicone gel implant to improve the situation. A gummy bear implant clearly was too firm, and the cohesive gel implant will improve the texture problem. Now that you are over stretched, you may need a concentric procedure around the nipple to reduce the loose skin.
Get another consultation from a Board Certified Plastic Surgeon to help with information to move forward. You may end up with some rippling, but it should be improved by changing to the correct implant. You already know that overfilling a saline implant only makes them round and hard
Good Luck.

Robin T.W. Yuan, MD · Answer

You are in the situation of chasing the imperfections of breast augmentation. Unfortunately, the fact that you have very little natural tissue to cover your implant means that your breasts will look and act like whatever implant you choose. All implants have imperfections and this is more the case as more of the final breast volume is comprised of implant. "Overfilled" saline and gummy bear implants feel firmer, while "underfilled" implants have ripples and wrinkles. Silicone implants have a higher risk of capsular contracture. Shaped implants are textured and textured implants show more ripples due to tissue adherence. You'll have to pick the imperfection you are willing to live with (i.e. firmness vs. rippling).

George J. Beraka, MD (retired) · Answer

Hi!  There is absolutely no reason for you to be a DDD cup. One can use overfilled SMALL implants.
Your tissues may be quite stretched and thinned. So I have a radical suggestion: Have your implants removed and wait a year to let the tissues recover. Then you can start from scratch.
Almost always, the outcome is not determined by the implant. It is determined by the planning and the choices and the execution of the surgery.
 Rippling can almost always be avoided with Mentor silicone gel, round, smooth walled moderate PLUS profile or high profile implants. What you cannot use are so called moderate profile (really low profile) implants which are underfilled and will cause rippling.
You don't need custom made implants.

Is It Possible to Order Customized Breast Implants?

Answers (10)

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