Saline Vs Silicone & What CC Size. 5'5 120 Lbs VERY Active? (photo)

HI! I'm debating between saline & silicone, leaning more towards silicone. My main concern is that I want to be symmetrical. Currently I feel as though I am AT LEAST a 1/2 cup smaller on my right. I am very active and frequently run marathons & lift upper body. I don't want to sacrifice my workout but would like to be a full C. I am also concerned about the incision site leaving scarring or causing a loss in sensation. Also the placement, i'm 22 but would like to nurse someday (YEARS). HELP!

Doctor Answers 8

Implant choices

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Some asymmetry is common between breasts. As for saline vs silicone that is a personal choice.  Different implants can be placed if there is a big difference.

New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Breast Augmentation in Athletic Patient

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With regard to implant choices to enlarge your breasts, there are a number of things to consider. Your chest circumference and breast width are very important factors when choosing an implant.

The best thing to do is to try on some sizers in a non-padded bra at your plastic surgeon's office to figure out what YOU think looks good. You should be able to place a larger sizer in your bra on the right vs. the left to see if your volume evens out. Don't get hung up on cup size or even implant size. After you've made your decision, ask your surgeon if he or she thinks the implant you've picked would safely fit within your body's measurements. In general, an implant should be selected with a diameter that fits within your breast width. This will help to avoid certain complications. Plus, larger implants can certainly impede some of your activities, such as PT or marathons. Do you really want to carry an extra heavy load for 26.2 miles?
All breast augmentation incisions will leave a scar. Some incision sites may could be more prone to nipple numbness than others. 
Placement of the implants above or below the muscle will not diminish your ability to nurse, as long as you would have been able to nurse without implants.
Thank you for your question and photos. Best of luck!
Gregory C. Park, M.D.

Gregory Park, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 177 reviews


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You need to see a Certified PS to give you adequate advice. It’s hard to give it over the internet without seeing your body proportion. In our office we tell our patients that 200-225cc equal to about one cup size. Whether you go with saline or silicone the best way would be under the muscle so there is less chance of rippling. Our most popular incision is around the areola the skin is very thin and the scar is very forgiving. In regards to asymmetry that is very common in women that can be fixed with saline adding more on one side then other or silicone using 2 different sizes. You will never be 100% symmetrical. Good luck


Stuart B. Kincaid, MD, FACS (in memoriam)
Beverly Hills Plastic Surgeon

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Size for Marathon Runner

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  The size of the average breast implant placed in the US is 350 ml.  Having said that, the average woman does not run marathons.  It may be more appropriate to select a smaller implant.  Size discrepancy can be improved with differential volumes.  For women with little breast tissue and/or little body fat, silicone may be a better option.  Kenneth Hughes, MD breast implants Los Angeles, CA

Breast Augmentation with Mini Ultimate Breast Lift for asymmetry

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Silicone gel implants look and feel more natural than saline and the best position is behind the muscle.  You are focusing on breast size but more importantly is a breast lift.  You need a circumareola approach for both breasts.  Using this technique your breasts can be reshaped and lifted higher, more medial and reshaped to match.  Through the same incision the implants can be placed augmenting both breasts to the size you desire to correct size asymmetry.  You have not stated what your beginning size is,  just you desire a size C.  If you are size 32 or 34 each 100 cc of implant will correspond to 1 cup size change.  If you are size 36 or 38 each 200 cc of implant will correspond to 1 cup size change.  From this, you can compute the volume required to achieve your desired goal.  This technique does not interfere with breast feeding and maintains nipple sensitivity.  You may be a candidate for Breast Augmentatin with Mini Ultimate Breast Lift.

Best Wishes,

Gary Horndeski, M.D. 

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Several issues to decide

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There are multiple issues to address or consider here:

Properly sized, positioned, filled (saline), and below the pec major, both saline-filled implants and gel-filled implants can look the same. Saline-filled implants have multiple advantages but one big disadvantage in that they don't feel like tissue when there is not enough tissue coverage over them. Gel-filled implants have a number of disadvantages but one big advantage that they feel like tissue regardless of the coverage. 

Currently there is no simple way to measure breast volume before or after augmentation and external sizers are misleading. It does not appear that you have a 1/2 cup of difference in volume between the two sides but the right breast is clearly higher on your chest than the left one. A breast implant even if different sizes will not correct this and the bigger or higher profile implant will tend to accentuate the difference in position on your chest. Lowering the crease level on the right will help but this has to be done in a controlled manner with a dual-plane release of the pectoralis muscle and will still leave the nipple-areola higher. Ideally the width of the implant needs to be the same for both sides. This makes it harder for gel-only implants to compensate for volume differences. 

The best incision site for short term and long term has turned out to be in the inframammary crease for a large number of reasons. This can be as small as 2 cm for a saline-filled implant and about 3 1/2 for a gel-filled implant. 

As for serious upper body activity, I recommend one week off completely after a breast augmentation to allow for healing, a second week of controlled lower body exercise only, and after two weeks a return to full normal activity as if coming back from a shoulder or muscle injury -- that is, not all at once but start stepping it up. By six weeks in most patients you should be back to considering the marathon or major upper body stress. 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Saline Vs Silicone & What CC Size. 5'5 120 Lbs VERY Active?

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Good concerns and the self posted photo demonstrates issues. You have chest wall, breast asymmetry that is moderate to severe. ONLY in person evaluations will afford you the opportunity to fully understand these issues. 

Concerns about Breast Augmentation?

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Thank you for the question and pictures.

As you can imagine, it is not possible to give a precise advice without direct examination and a full communication of your goals. The good news is is that you are starting at a good place when it comes to breast augmentation surgery.

 Prior to undergoing breast augmentation surgery careful  selection of your plastic surgeon and communication of your goals will be very important;  I would suggest that you do not base this communication ( or your satisfaction with the results of surgery) on a specific cup size.  Goal pictures and an emphasis on achieving a “proportionate” (given your height and weight) result  may be helpful.

In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup" etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. 

In regards to breast symmetry,  I always tell patients that some breast asymmetry is to be expected after breast surgery, despite best efforts. The breast will be “sisters, not twins". Achieving realistic  expectations  prior to surgery is important.

Some general words regarding the use of saline versus silicone breast implants may be helpful to you:

The type of implant used may Influence the final outcome  of the procedure, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.

On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
 Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.


I hope this helps.

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.