29 yr old, 125lbs, 0 kids, workout frequently. Had my Pre-Op appointment this morning. my doctor stated the best for my measurements is 300CC overfilled to 350+ Saline HP SubFacial Implants. I want to look like the post-op photo i found below which i did show him and he said it will be very closely similar. What are your thoughts on HP subfacial saline implants? I am nervous they will droop bad not being under the muscle and/or too much rippeling for subfacial.
300cc Overfilled to 350-370cc Natrelle Saline HP SubFacial Breast Implant? (photo)
Doctor Answers 17
Saline implants and long term issues.
I've never really been impressed with the claims of subfacial implant placement. In essence, it's simply a subglandular placement of the implant. For saline implants, subpectoral or dual plane is typically advised to reduce rippling. However, if there is plenty of soft tissue coverage ( > 2cm in the upper pole) then subglandular placement rarely leads to visible upper pole rippling. Drooping of the breast has a lot more to do with the skin tone and the size of the implants than the pocket placement (submuscular vs. subglandular). Be advised that high profile implants will give you an "augmented" look. I do agree with overfilling those saline implants to reduce the rippling that tends to occur.
Sizing Questions with Breast Augmentation
In general, one cup size increase occurs with 200 cc to 250 cc. Therefore, a 350 cc increase would be about 1.5 cups. Other than these general ideas, the best thing to do is to try the volumes on to get a sense of how large these are. Kenneth Hughes, MD Hughesplasticsurgery Los Angeles, CA
Thanks for this question and photos. The sizes mentioned are within the ballpark to achieve a solid augmentation. The bigger you go, then the less likely it will look natural. The final cup is better determined after examination and seeing your natural shape by your plastic surgeon. Best wishes, Dr. Aldo.
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In your case, I would consider using silicone under the muscle instead of saline. You are thin and you stated that you like to work out frequently; hence, I think your concerns are reasonable. With any implant/ breast, some drooping with time/ age is inevitable. However, drooping would be minimized by going under the muscle. Be advised that with any breast implant future surgeries may be required (hopefully years down the road) as they do not last forever. As you age, if drooping occurs, you may - someday- be a candidate for a breastlift. This is usually done at the same time as removal/replacement of implants. Just food for thought. Good luck.
Saline Implants SubFacial #breastimplants
In my practice you are the kind of patient that I would likely place sub-muscular implants and use silicone. I think they are more natural feeling and there are many reasons why I like the sub-muscular dual plane the best. Rippling is less with implants below the muscle. In the pocket you describe I have seen implants drop much faster over time. The chance of rippling is higher above the muscle and with saline. At the end of the day if you trust your surgeon and you have conveyed your goals then that is all you need to know. I usually only use the sub-glandular pocket for very athletic patients who do not want to worry about the pectorals animating the implant. Body builders are specifically the patients I would place implants in that pocket. Follow your heart. If you trust your surgeon then proceed. If not get a second, third, or fourth opinion. Get as many as it takes.
Silicone Gel Implants under the M
There is NO reason that you shouldn't have silicone gel implants...they look and feel more natural, don't ripple as often and are less prone to rupture. The implants should be placed under the muscle, probably using the dual-plane technique. 100% of the Breast augmentations I show on my website were done with implants under the muscle...
You should not have Subfascial placement of the implants because it is essentially the same as subglandular (under the breast tissue) and you may have all of the complications you mentioned and potentially even more!
Saline Implants Subfacial
I also have been unimpressed with the claims of subfacial implants. Even if placed subfacial, the tissue is exceedingly thin and offers minimal benefit. You will certainly hear different opinions and I'm not saying that it is wrong but rather a surgeons preference. I prefer dual plane submuscular placement. I would recommend considering another opinion if you have any doubts or concerns. You would need to be examined to be any more specific on answering your questions.I also feel that subpectoral implants tend to look better with time while subglandulars don't.
I dont like the high profile look. I dont think it looks very natural. I also dont usually place subglandular or subfascial implant because the submuscular implants seem to do better long term.
Although your size choice is in the ballpark, I usually like to place saline implants under the muscle to minimize rippling. If you want to have the implant in the subglandular or subfascial location, then a silicone implant might be a consideration.
High profile above muscle implant placement
It looks like the implant size and shape chosen should be able for you to achieve the volume that you wanted. There are two main concerns with using saline high profile implant on thin woman and going above muscle. First is the rippling. Most of the time the rippling becomes more pronounced after 1 to 2 years of your surgery, not right away. It's usually at lower part of your breasts. However, when the implant is above the muscle you are more likely to get rippling even at upper part, especially when you lean forward. Once again this issue usually becomes apparent after several years, not right away. Second is the overall breast contour, especially the upper pole. You are more likely to end up with a "shelved" look when the implant is place above the muscle and especially high profile implant. Once again, you wouldn't see this right away but typically after a few years. Most of the pre and post photos out there are taken within one year of the surgery. When I evaluate long term results, it's apparent that rippling and shelved look are quite common with high profile saline implant placed above muscle on thin woman. I think you went through a thorough evaluation of your surgical options, just a reminder for my patients to consider longterm consequences as well.
Stewart Wang, MD FACS, Wang Plastic Surgery
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.