Smooth implants or textured? Round or tear drop? Under muscle or Biplane?

Hello and thank you for your question. It is highly recommended to use smooth implants to avoid concerns of anaplastic large cell lymphoma associated with textured implants. I recommend a round implant as it avoids future issues with cosmetic deformity when the implant rotates. Under the muscle or above the muscle just depends on your anatomy, skin quality, physical activity levels, body habitus, and measurements. All of these things need to be taken into consideration during a consultation.
Alex Zuriarrain, MD, FACSQuadruple Board-Certified Plastic/Cosmetic SurgeonCleveland Clinic Trained

Hello,
Thank you for the question.
Based on what you are describing, you appear to be a good candidate for breast augmentation, but it is difficult to tell definitively without an in-person examination and seeing the photos.
Implant size discussion and implant selection is one of the most important steps during your consultation with plastic surgeon. The decision-making process depends on your desires, as well as breast and soft tissue dimensions of your chest wall. I also utilize Vectra 3D planning to further help with implant selection.
The breast implants are typically placed under the muscle to provide more soft tissue coverage using a small incision at the breast fold.
I would seek an in-person evaluation by the Board-Certified Plastic Surgeon, in order to discuss your goals and concerns for the best cosmetic results.
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Smooth round under muscle. Textured and teardrop implants have too many problems. And submuscular and biplane are really the same thing. Easy decision

Dear Friendly695766,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

I recommend an in person consultation with a plastic surgeon to discuss your goals and be measured. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size and style breast implants, and they choose what looks right for them. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon's experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what size and style breast implant is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

For women with small breasts, I recommend smooth round implants placed behind the muscle for better upper breast fullness and coverage, and fewest long term risks.

There is so much to consider when selecting the right implant and the questions you mentioned are just a few. There is also the type and profile to consider. Breast implant selection is always best when done in person. During a consultation you'll be examined by your board certified plastic surgeon and discuss your goals for surgery. Together you will select the implant that is best for you. Based on the information given in your post you will likely have a nice outcome from a smooth, conservatively sized implant placed beneath the muscle.

I would recommend smooth implants placed under the muscle. I do not see the benefit of using textured implants and do no even think most companies are making them anymore. In terms of implant placement, unless you are a body builder or are big into working out I believe submuscular is the way to go. In your case I believe placing the implant on top of the muscle would not look good in the end. Your surgeon can choose to do a dual plane technique if they wish and the extent of the dissection is up to them though you probably do not need anything more than a 1, if that. Good luck