I need advice deciding between Mentor Siltex Round Moderate Plus Xtra 350 (12,2⌀) and High Xtra 340 (11,1⌀) (Photo)

Question

It is important for me to get the diameter correct, to avoid either the uniboob effect (too close to each other) or the ball-in-sock (too far from each other) When I measure my entire breast width, side to side, it comes to 12cm, but when I measure over the nipple, it comes to 11cm. Which is correct? See pic. If 12cm then the 350cc makes sense to me. But if 11cm, then the 340 makes more sense, not only to fit my chest size better, but also to avoid chances of rippling. Weight 120. Height 5,5.

Finny George, MD · Answer

Hi, thank you for sharing your question. The base diameter measurement is usually taken away from the nipple and along the base. So, it sounds like the 12cm may be the correct measurement. Your surgeon will best be able to answer this question because he/she was able to assess your soft tissues. You may want to consider a Vectra 3D simulation to see what each of these implants look like prior to committing to one. Consult with your board certified plastic surgeon to review your options. I hope this helps. Best of luck!

Kenneth Hughes, MD · Answer

Hello, thank you for your question. A board certified plastic surgeon will be able to guide you to the correct size implant. Based upon measurements of your chest wall and breast imprint width as well as knowledge of all breast implant sizes and profiles should make this process easy. Try on a profile bra with various silicone sizers your PS recommends under a tailored blouse, tank top, bikini, workout clothes, and other garments you typically wear so that you have the best idea of whether the garments fit as desired with the implant selected. Select the size that boosts your self-esteem, and fits your anatomy. Choosing an implant based on an aesthetic goal that exceeds your anatomic capacity may lead to complications and possibly revision later in life.

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend an in person evaluation by a plastic surgeon to be measured and discuss your goals. After I measure and discuss goals with my patients, we then look at pictures of former patients with similar measurements with different size and style breast implants. My patients tell me that this process is very helpful in determining what size breast implant is right for them. They also get to see what they would look like when the implants have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved.
Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author                                
RealSelf Distinguished Hall of Fame Inductee

Daniel Barrett, MD · Answer

Dear Witty328943,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Gerald Minniti, MD, FACS · Answer

I'm very impressed with your attempt at biodimensional analysis on yourself, however studies show that any given measurement is dependent on the person doing the measuring.  So, it's best to have a surgeon who relies on this technique for accurate measurements leading to proper implant selection. Further, there is more to these measurements than just width of the breast, and the addition of measuring the 'nipple to fold distance on stretch' tell a much more complete story of your soft tissue dimensions AND dynamics. Your nipple distance is high above both the bottom of your breasts as well as the inframammary fold (which I can't see but can estimate its position), and your breasts have a flattened appearance with substantial tissue 'hanging' below the fold. This indicates that you might have soft tissue laxity and poor elasticity, putting you at risk for implant migration and dropout; a physical examination would be needed to confirm this presumption. With this in mind, I caution against any implant that is more than moderate plus in profile, as high and extra-high profile implants have the greatest propensity to drop out and become ball-in-sock in appearance (their more spherical shape enhancing that effect too!). I also caution against an implant that is too large, which I realize is all relative to not only your body dimensions but also tissue dynamics. Choosing textured implants will absolutely not secure your implant from dropping out. The 'Velcro effect' will not happen at all with Mentor's Siltex, is rare with Sientra's proprietary texture, and only occurred in Natrelle's Biocell a quarter of the time. As a side note, Biocell is off the market around the world due to it's high risk of lymphoma (1/2000). The other manufacturer's textured devices are safer, but not risk free of lymphoma, with rates of 1/70,000 and 1/80,000 for Sientra and Mentor, respectively. The use of textured implants inevitably means you are choosing an implant with a thicker shell, which can transmit implant wrinkling more effectively to the surface, leading to more likely palpable or visible irregularities. Unfortunately, Mentor silicone gel is the lowest cohesive gel on the market, which although makes it soft, puts you at higher risk for implant wrinkling as well. To summarize, my recommendation is a moderate or moderate plus profile implant with a smooth shell, and either moderate or slightly higher gel cohesivity. You are NOT at risk for symmastia (uniboob) or unnaturally close cleavage. My personal preference is the Sientra luxe line with either their HSC or HSC+ gel cohesivity, which compares to Natrelle's intermediate gel cohesivity known as 'responsive'. With regards to implant dropout, what you do after the surgery is just as important as what the surgeon does during the surgery to ensure implant placement and position. A snug bra that's not too tight should be worn extensively for three months in patient's like you, and all chest exercise should be put on hold for the same period of time.

Payman Danielpour, MD, FACS · Answer

Thank you for your question.I think that the best way for you to visualize different sizes and profiles of breast implants on your breasts is to have a 3-d simulation.  I routinely perform this with every breast augmentation patient in order to properly choose the implant size and projection.  Best of luck!

Nelson Castillo, MD · Answer

Thank you for sharing your question and photograph.  I prefer to see inspiration photographs of women not in clothing to get the best representation of a patient's goals, so I would recommend continuing to work with your surgeon to figure which profile would provide you the closest approximation to your goals and select your implant in that way.  Hope this helps.

Johnson C. Lee, MD · Answer

It is best to have an in-office evaluation so that careful measurements can be taken to determine the best size implant for your chest diameter, several upper body measurements, and current breast tissue. Once you have the measurements, they are all put together to determine the right implant from the right manufacturer. Breast implants of the same cc's can look and feel extremely different depending on the profile and material. In my office, I have the MENTOR breast implant sizing system where different size molds are used to simulate how you appear in your own clothes and help finalize your decision. Hope this helps!
Johnson C. Lee, MD 
Board-Certified Plastic Surgeon

David Nguyen, MD · Answer

Hi Witty328943,
The two implants probably won't create much of a different look for you. The more important thing to address is the use of textured implants. There is a risk of BIA-ALCL (a type of cancer) when using textured breast implants for augmentation, and I would have a lengthy discussion with your surgeon about that prior to proceeding. Blessings on your journey!

Connie Hiers, MD, FACS · Answer

Your surgeon, who has examined and measured you, will be the best one to decide which profile works best for you. You will not notice the 100 cc difference between the two breasts.

I need advice deciding between Mentor Siltex Round Moderate Plus Xtra 350 (12,2⌀) and High Xtra 340 (11,1⌀) (Photo)

Answers (12)

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