Should I get silicone gel, high or moderate plus and what size? I want to be a D.

Question

Had saline 300cc for 10 yrs removed last year. I went from A to C cup. they were super hard and stiff! couldn't even wear normal bras

Keith Hodge, MD · Answer

You appear to have a petite frame, so with that in mind, I would suggest a high profile silicone implant. This should give you the volume that you want without the implant being too wide for your frame. An in person exam will be needed to recommend a specific volume. Good luck!

Nelson Castillo, MD · Answer

Thank you for your question and photographs. Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend seeing an ASPS board certified plastic surgeon, they are in the best position to ensure that the implants the two of your decide upon are the right ones to meet your expectations. It sounds as if it may be wise for you to "try on" several of the implants so that you can have a better visual representation as to what they would look like. I would favor silicone implants placed beneath your chest muscle to help avoid a recurrence of your breast hardening. Best wishes!

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation.  The size, profile, and shape 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.  This entire surgery
can be performed with a small incision technique.  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.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Joshua Lampert, MD, FACS · Answer

Patient satisfaction regarding implant choice is very high when done appropriately.  I encourage patients to spend necessary time with their ABPS board certified plastic surgeon and patient care team.  Try on different sizers in the mirror and pick a size.  Bring a significant other, friends or family - if you value their opinions.  Based off chest wall measurements and desired size an implant is selected.  Dont rush! Good luck.

Jaime S. Schwartz, MD, FACS · Answer

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

Timothy Fee, MD · Answer

These choices are related to profile or the amount of projection the implant will provide. This means how far the implant/breast pushs out in front of your chest. Your breast and chest size will require sizing such that a variety of implant projections could be tried during surgery to see which style and size your surgical team thinks is the best for you. Good luck.

Steven Wallach, MD · Answer

You need to be seen in person to determine what type of implants and size would be appropriate. Best of luck.

Robert Singer, MD · Answer

The best cosmetic result in any particular breast augmentation patient depends on a variety of factors, including: Your individual anatomy, realistic expectations, a thorough discussion with the plastic surgeon about the options, and an understanding of the pros and cons of any particular implant choice. Proper sizing is not just about the number of cc’s. or the type of implant. The thickness of your tissue, breast dimensions which include the width, height, and projection, as well as chest wall width all need to be considered when choosing an implant. Trying on implant “sizers” of various shapes and volumes while wearing a tight t-shirt, bra, or bathing suit at a preoperative visit will help you and your surgeon choose the optimal implant.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Joshua A. Halpern, MD, PA · Answer

Thank you for your question. During your consultation I like to find out your goals (I.e. What cup size you would like to be). It's important to measure the width of your breast to determine which implant you need. I like to use breast sizers that are made specifically to try out before surgery. Mentor has a good set. The patient puts on a bra and she can place various sizes over her breast. When she looks in a mirror she can see which size she likes best. During surgery I like to use intraoperative breast implant sizers to confirm the size. I use the bloodless breast technique which I invented. Bleeding is minimal, typically there is no bruising after surgery, and recovery is a lot quicker versus traditional technique. For more information please see the enclosed video and I hope you find this information helpful.

Benjamin J. Cousins, MD · Answer

Hello and thank you for your questions. Remember, it is best
to see a Board Certified Plastic Surgeon who can in person examine you, take
key measurements and go over with you your specific aesthetic goals. Bringing
several photos of your "ideal" look can be helpful as
well.  Also with my complimentary consultation is a review and discussion
about incision location, implant placement, implant size and shape, type of the
implants and recovery period. There are several key differences and some
similarities in the types and shapes of breast implants. It is best to see and
feel in person the different sizes, shapes and textures of the various implants
during a consultation with a Board Certified Plastic Surgeon. All the best.
Benjamin J. Cousins M.D.
Board Certified Plastic Surgeon