Sientra shaped round HP 425cc or Natrelle 475cc style 20? (photos)

Thanks for using one of our patients as your goal photo (first one on the left). But your third goal photo shows a woman wearing a push-up bra giving her a high, round, Baywatch coconut look. That is the effect of the bra, not the implant.You do not need shaped implants since smooth round implants are teardrop-shaped when standing up, and flatten and round out when reclining, just like natural breasts do. Form-stable implants remain teardrop shaped even when reclining, which is decidedly NON-anatomic! Further, textured implants adhere to tissues, and therefore do not move as naturally as smooth round submuscular implants do.I'm also a bit concerned that your surgeon doesn't offer all sizes to try on. Does this mean he has to order implants in advance of surgery? In our surgical facility we stock multiples of each implant size and each implant profile, so they are always in stock and we never have to tell a patient "Sorry, we didn't have that size available."That being said, I agree with his comments about sizing--50cc is 3 tablespoons and 1 teaspoon (not a lot, and not even a visible difference in most cases.But yet he also allowed a misconception about silicone cohesive implants to go unmentioned. Both Sientra and Natrelle silicone gel implants are cohesive, and often mistakenly called "gummy bear" implants. However, the actual true "gummy bear" implants are the Allergan style 410 "highly cohesive" textured-surface form-stable (teardrop-shaped) implants. These are more firm than the Sientra or Natrelle silicone implants. All are cohesive, but the 410s are "highly cohesive" and are therefore more firm to touch. Just so you know.Choose the larger Allergan Natrelle implants in the widest width that matches your actual pocket width. If you are really that narrow, then high profile it is! Best wishes! Dr. Tholen

Hi Isamom,I already know you
are seeing a board certified plastic surgeon because Sientra only sells to BC
plastic surgeons (by ABPS - The American Board of Plastic Surgery)
who are members of ASAPS (The American Society for Aesthetic Plastic
Surgery) and or a member of ASPS (The American Society of Plastic Surgeons). So that is great!I would simply focus on what size you want to be, not on a specific shape.  All companies have many, many sizes and dimensions to meet your needs. Also Sientra is the only implant company who has a warrantee if
you develop a capsule after receiving their textured implants. They have
a special process which makes the texture. This implant shell
is unavailable elsewhere.Here are a few tips for you as you are still wrestling on your size.This is perhaps the hardest decision for
a patient to make, as well as the surgeon. Cup size estimates can be
misleading, but I generally advise patients that they will experience an
increase of approximately one cup size per 200 cc. You can try on implants in
the office by placing them into a special bra.Approximately 50 cc (1-2 oz.) is added to the final volume to account
for flattening of the implant in the partial submuscular pocket. Once you
decide on a size you like, then add on about 25-50 cc, because in real life the
implant will be flattened slightly by your tissues.Multiple measurements need to be taken to fit
an implant to your exact anatomy. Have your surgeon's office show you the
charts of the implant dimensions for the various profiles of silicone and
saline from the manufacturer. Then you and your surgeon can piece
together the puzzle by matching your measurements, with your wishes, versus
your tissue cover and the available implants to arrive at a surgical plan.Keep in mind larger implants tend to have
more problems over the years.Since
silicone implants wrinkle less than saline implants, they might be your best
bet.You can also approximate this at home by measuring out an equivalent
amount of rice placed into a cutoff foot of old panty-hose, and put this in
your bra.Wear this around the house for
a while, and see what you think.Implant
size must square with assessments of tissue cover, breast diameter, and chest
wall width. Multiple measurements of your chest wall are taken (seven in
total). Implant size selection has been
an issue of much discussion. Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape. A photo album of patient pictures is maintained to assist them.
These photos ultimately help in determining where the implants will be placed,
since they can be shifted inside (to provide more cleavage), to the outside, up
or superiorly, and down or inferiorly during surgery. In determining the final
size selection, I always place the highest priority on the preoperative
measurements and potential tissue cover. Then, the patient’s verbal requests
are factored into the analysis.Our
average size over the last 6,000 implants was 350.

In my opinion, the biggest difference between shaped and round implants is the fullness in the upper pole of the breasts.  If you want a more full look in the upper pole, go with the 475cc round implants.  If you want a more natural look in the upper pole, go with the 425cc shaped implants.Don't get hung up on the term 'gummy bear'.   It not a real term and is used so many different ways that it isn't even really clear what it means anymore.