I Already Have Silicone Breast Implants? (photo)

Hi as mentioned I already have high profile 375cc silicone by mentor over the muscle. Now I lost the volume up top I want to do another operation with mentor or inspira as i heard that they keep their shape better for a 560 cc in ultra high profile my width is 14cm and now my implamts are 12cm I want more projection . Can I achieve that over the muscle or dual plan I feel a little rippling in the inside of my breast because I am so thin . That bothers me since I have textured should I switch to smooth?

Doctor Answers 10

My regrets

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You are in a terrible situation and no matter what you will never look the way you want.

There wisest thing to switch to smaller moderate profile implants behind the muscle. 

The only exception to this is if you are an adult entertainer.  If so, such breasts may be critical for earning a living for your family.  Just like an NFL player who plays now but will have severe disabilities later, you must decide if you want to make that trade with your own body.

But I know from experience that someone who wants to look like the woman in the photo you show will pursue a series of revision operations that will cost thousands, destroy her tissue, and leave her worse off.

Your tissue is so stretched that you are already way too big.  Aside from looking fake and deformed, your tissue is being thinned, and even your rib cage is being depressed.

You eventually ripple - no matter the implant - with thin tissue and the implant in front of the muscle.  But if you just go behind with such thin tissue, you will have a significant amount of distortion of your breast when you contract your muscles.  The only way to reduce that is to put a patch of ADM along the lower portion of your muscle, though even this isn't perfect.

UHP implants were designed to replace an entirely absent breast in reconstruction.  It has only recently found a place in augmentation, but such breasts always look fake and very frequently cause skin stretch, rippling, and other problems over time because of the degree that they stretch tissue.

I feel sorry for you...I really do.  Because you will find someone who won't know any better and will tell you what you want to hear.  Only after three more operations when your situation is desperate will you finally start hearing a consensus of opinions about what happened to you. 

Los Angeles Plastic Surgeon
4.6 out of 5 stars 49 reviews

Upper pole fullness

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I think that worse thing you can do is go bigger given your frame and more importantly your tissue type.  As you are very thin and have little tissue to cover your implants you are going to run into several predictable problems. 

First as you bigger, irrespective of the implant type, your skin will stretch more, the breasts will get heavier and your breast will DEFINTELY sag more.  Initially the increased volume will look better because you will be swollen but 6-12m later you will have the same problem but only worse.  Given your skin type you are likely reaching your limit.  Additionally if stay above the muscle your rippling could get worse. 

Now if you decide to go under the muscle to increase the coverage and minimize the rippling then your bottoming out affects, that is sagging will accelerate as the muscle is now pushing the implant down every time you contract. 

There is TOO much emphasis placed on the implant type, size, projection, etc but unfortunately with individuals as fit and thin as you it is all secondary to your tissue which you cant change.  I do think a "gummy bear" or cohesive implant is probably a good idea because it will reduce the rippling as well as a smooth implant.

I know that may not be what you were hoping to hear but I have seen so many patients get into this cycle of bigger, saggier, bigger, saggier.  Just keep your tissue in mind.

Hope that helps and good luck


Rady Rahban, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 141 reviews

Changing implants

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You will not likely improve the rippling you are starting to get over the long term by placing larger implants even under the muscle.  The tissues over the implants will continue to thin with this large or larger implants over time, even if the new implants are placed under the muscle.  You current implants appear to need to be repositioned higher, especially the left implant.  The use of acellular dermis may help hide the rippling in thin patients.  Also, switching to smooth implants may help some with the rippling.

Todd C. Case, MD
Tucson Plastic Surgeon

Switching Implants

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I think you are right on with some of your questions.  I have used the Ultra-High smooth silicone implants for patients exactly like yourself with amazing results.  I don't think it is necessary to switch the positioning of the implants if you use the Ultra-High.  There are some shape issues that your photos show but these can be corrected when changing the implants.

There are several problems visible the photographs of these implants.

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The breast implants are large and visible contour irregularities. Switching to smooth walled gel implants is a start. Secondly there's too much volume below the horizontal pole of the breast. This may be due to sub muscular placement. At any rate you need to talk with the plastic surgeon about the aesthetic problems and potential corrections.

Breast implant replacement options

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Implants placed above the muscle can result in rippling for thin women, regardless of the implant type, but textured implants can be felt more easily. On the other hand, some evidence suggests that textured implants cause less capsular contracture when placed above the muscle. One way to reduce the implant palpability is superficial fat grafting.  As a long-term solution, though, I recommend changing the implant's position to below the muscle.  I am not aware of any solid data that a certain implant brand holds it shape better than another.

I Already Have Silicone Breast Implants?

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Love the UHP implants. But you need to be sure your expectations are achievable. Seek few in person opinions. 

Implant issues

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It looks like from the limited photo that you have some shape issues and implants that are too wide.  Best to be seen in person for a proper evaluation.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

I Already Have Silicone Breast Implants?

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I think that going under the muscle with help with the rippling longterm and palpability.  In addition, the change from textured to smooth will be possible with this transition.  Upsizing should not be an issue as long as that implant fits your chest wall.  You may or may not need pocket adjustment to raise the level of the implant.  Kenneth Hughes, MD Los Angeles, CA

I Already Have Silicone Breast Implants

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I am not convinced that larger implants will solve your problem. Both implants seem to be bottoming out, and larger implants may accelerate the process. It looks like the left implant may be up to an inch lower than the right, and that ought to be addressed in any planned operation. Bigger implants alone may temporarily fill the upper poles, but more of what you have going on now may continue and at a more rapid pace. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.