Any suggestions on 425cc textured HP silicone OR 590cc textured UltraHP? (photos)

Had 2 different Doctor consults on my breast revision surgery. One of my breasts deflated. I currently have 500cc saline. Both doctors had different thoughts on sizing and implant. I am not sure, which to choose. I'm 5'0 ft 112 lbs petite has had 1 child. 12.5cm 13cm. The choice I have to make is to choose between 425cc HP silicone textured OR 590cc ULtra HP textured. How do I choose? I DON'T pointy cone-like boobs. Just want symentery and nice look.

Doctor Answers 9

HP vs UHP

The easiest way to think about this is the following - the HP will give you nice fullness and volume for your frame.  The UHP will give you a more rounded appearance with more volume.  If you have 500cc already and like that volume, then I would cheat more towards the UHP device.  If you feel that you are a little too large currently, then I would go to the HP.  Just know that the UHP are pretty round in some women.  I hope this helps.

Different opinions for revisionary breast surgery…

I am sorry to hear about the complication you have experienced. It is extremely common to receive different opinions from different plastic surgeons about the best way to treat a specific “problem”. Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences.  



Although these different opinions can be confusing and a source of anxiety for patients, it is good for patients to understand the different options available. Ultimately, it will be up to each patient to do their due diligence and select their plastic surgeon carefully. Part of this selection process will involve the patients becoming comfortable with the plastic surgeon's experience level and abilities to achieve their goals as safely and complication free as possible. If I were you, I would ask to see as many examples as possible of similar patients who your plastic surgeons have helped.


Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery is:



1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.



2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 

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 “nice look” or "C or D 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. 



3. Once you feel you have communicated your goals clearly,  allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.

I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps.


 

Implant volume

You can do a baggy test to see which volume you prefer. This can give you a rough idea. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Implant choice

Hello and thank you for your question.  The size of the implant is based on your desired breast size/shape, your chest wall measurements, and soft tissue quality.  This decision should be based on a detailed discussion with equal input from both you and your surgeon.   Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and evaluate their results.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 79 reviews

Breast augmentation

hello and thank you for your question and photos. 

This question is best answered in the office, where you can be measured and examined. Generally, it is also best to have the opportunity to try on several sizers to see how the implants fit your frame. 

I would suggest doing the rice test at home. If you already like your current sized saline, you could opt for a similar size silicone. There are more options than just 425 or 590? There is 450, 475, 500, 550....  

Take a pair of nylons, fill each with dry rice ( 1 ounce = approx 30 cc ) and wear that inside your bra for a day. It will give you a good idea of how much added volume will make you feel. 

I would avoid the ultra high profile implants. Although they can give you strong projection, it may not fill your breast diameter. A slightly wider implant will give you a more natural shape. It can also be a little "pointy"

You should have several consultations with board certified plastic surgeons before making any final decisions. 

As always, best to be healthy, no smoking, and make sure any health concerns you have are managed by your primary care md. 

Best to you.

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 16 reviews

What size?

Ask your PS to show you implant sizers on the deflated breast to give you a sense of size. I always feel that looking at the implants on your frame is most helpful.

From the photo your  undeflated breast looks proportionate and natural, have you considered keeping the same size if you were happy?

At 5 feet I would be concerned that an ultra high profile  590 will be far less natural than what you have.

I have included a link about sizing below. I hope it helps.


Adam Tattelbaum, MD
Washington DC Plastic Surgeon
5.0 out of 5 stars 90 reviews

Breast Augmentation/Breast Implants/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision

I appreciate your question.

The size of implant best for you is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

Silicone will give you a fullness at the top (upper pole fullness).

Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.

These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon


Sizing Options

Hello,


The second implant size you've listed sounds overly wide and large for your frame and base width measurements. The 425 HP would be more logical and still fairly full. My patients find it helpful to try on implant sizers in teh office with a form-fitting T-Shirt in order to get an idea of the look. You could try on home made sizers as well. Since there is a significant difference between the sizes you have listed you should get a sense for which one feels more comfortable when you try that.

All the best 

Any suggestions on 425cc textured HP silicone OR 590cc textured UltraHP?

Thank you for your question. If you liked the size of your breasts before they deflated, perhaps consider staying with 500cc. It is difficult to provide advice without an in person consultation. The implant recommendation will change depending on your desires. 

Best, 

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 425 reviews

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.