Should I Reduce 450cc to 300cc W Local, Gummy or Regular Cohesive?

Doing implant exchange w local (450cc silicone HP May 2012 preop 32A). PS stated I have excellent skin quality and although I am 40yrs old he expected excellent contractile results. He chose HP silicone 300, 325, 350 range. When I asked about 300's he stated they would sit lower on my chest. Does that mean sag or less upper pole fullness? PS said Allergan gummy bear implant different from Sientras and that I have to be a candidate. Also explain benefit of getting a more highly cohesive implant.

Doctor Answers 5

Breast Implant Exchange for Cohesive Silicone

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Without measurements and an exam, I cannot comment on the exact size of the implants. However, I can tell you about the implants. "Gummy Bear" is just a coined term for cohesive gel. For round implants, the cohesive gel is essentially the same in Sientra, Allergan (Natrelle), and Mentor. Allergan's new anatomic implant does use a slightly different gel, bit the difference is only in the feel. Anyone can be a candidate for either. All the implants today are equally cohesive. As far as how an implant will sit, this depends on the base width of the implant and not the size. It is also the base width that is important in selecting an implant once a general size has been determined. Hope this helps.

Highlands Plastic Surgeon

Specific breast implants require specific information.

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It is not possible to recommend a specific implant without a proper history and physical examination. The get these types of questions answered a consultation is required. Changing from one high profile implant to another, smaller high profile implant has some hazards associated with it. The diameter reduces along with the volume, and tightening of the capsule is usually needed to keep the implants in their optimum position. Using a moderate profile implant can be used to maintain the width and upper pole fullness while still decreasing volume and projection. Placing a shaped implant has specific indications, if you don't have them, you may not recieve the benefit of the shape, and may suffer only the downsides of an asymmetrical implant. If you are confused about your choices, reconsult with your surgeon and consider getting a few more opinions from plastic surgeons exprienced with breast augmentation revision surgery.

Joseph Mele, MD
Walnut Creek Plastic Surgeon
4.5 out of 5 stars 17 reviews

Downsizing a year later

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I assume you are simply just too large with your current implants... did you select them or did your surgeon recommend them?  How are you deciding on how much to downsize?  Are you looking at implants to appreciate better how much smaller you really want to go?  All of these are important questions because you certainly do not want to still have an unsatisfactory result.  Your implants should be chosen according to your breast and chest dimensions and simply downsizing  HP implants will decrease the width of your breasts.  Is this what you want?  Finally, most people will not appreciate the differences between a Sientra or Allergan gummy bear implant... they both hold their shapes when cut.  You need to clarify all of your concerns with your surgeon before having your revision or you may end up still being unhappy with results.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Implant choices

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At present patients do have a choice to use cohesive gel  or the more traditional get implants for breast augmentation. What is best or you really depends upon your goals.

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

Implant type

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The new natrelle 410 is a highly cohesive anatomic shaped implant that differs from the other less cohesive products.  It only comes shaped in the US and has been shown to have a lower capsular contracture and has no known cases of the gel migrating outside of the capsule in case of a rupture.  Not all patients are candidates or may chose a shaped device.  However, in the right pt. they are an excellent choice with a nice shape and feel.  If you desire or need more upper pole fill, the shaped device may not be for you.  I have been an investigator for the 410's since 2001 and many patients and doctors do not understand the advantages and disadvantages of this implant.  Make sure your surgeon is comfortable with this implant and that you are an appropriate candidate.

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.