What are the best implants? I'm getting gummy bear round high profile. (Photo)

Question

I've been contemplating having breast augmentation for several years. I have finally committed, and am scheduled for surgery on July 5th. Although I'm excited, I still feel confused. I had my pre-op consult and sizing today. I'm 39 years old, 5'5, 125lbs, and a mother of two. I wanted to go big, and decided on 485cc round, high profile gummy bear implants. I thought of 505cc, but am still undecided. Does anyone have these implants? How do you like them? Do they feel and look natural?

John Mesa, MD · Answer

All the silicone breast implants available in the US are excellent devices for breast augmentation.I particularly like more Sientra silicone breast implants because their shape, texture, capsular contraction rates and most importantly, they are sold only to board certified plastic surgeons ( so no dentist, gynecologist, general surgeons or other plastic surgeon-wanna bees can place them).The best size of breast implant is the one the patient, not the surgeon chooses. No patient should go to the operating room with doubts about the size they want. Any patient with second thoughts about their breast implant size should follow up with their plastic surgeon and confirm the size of the implants before they go under the knife.

Gary M. Horndeski, MD · Answer

While I agree that your wish pics are indeed beautiful, those women did not start out with your degree of sagginess, so please do not expect the same results. You will need a breast lift before contemplating an increase of volume that high. Should you decide to move forward without a lift, your surgeon will need to cut a lot more tissue to make them fit, thus potentially making it easier for them to become displaced or malpositioned  (dual plane approach) sooner. Please know that breast implants are not life time devices. The larger they are - the heavier they are - the sooner they will move out of place. Please consider a smaller size or be ready to wear supportive bras 24/7 to help minimize complications. Best wishes,

Emmanuel Mallol Cotes, MD · Answer

Thanks for the question. I prefer use the Cohesive Gel - Silicone Breast Implants with textured cover ("gummy bear implants") They are quite safe and aesthetically best as they give a firmer consistency, better projection and natural appearance.Kind regards,Dr. Emmanuel Mallol.-

Stuart A. Linder, MD, FACS · Answer

Roundest implant available today would be Srx highest profile silicone rather than gummy bear. I do not prefer gummy bear or anatomical implants in your body because of rotation problems and less fullness upper poie.

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

Director-Beverly
Hills Breast and Body Institute

#RealSelf100Surgeon.

Scott W. Vann, MD, FACS · Answer

The difference in 485 and 505 is minimal and I usually recommend if a patient is stuck between two close sizes to round up to the larger. There seems to be less post op concern if they do. Your final look and feel will have more to do with how your implants are placed. I would do a dual plane dissection and generally I think this gives the most natural result and best chance at long term softness. I think your cleavage will improve some, but your surgeon has to put your implants directly behind the nipples. Good uplift bras make a lot more cleavage than surgeons do. Good luck.

Darryl J. Blinski, MD · Answer

The size in volume difference is ONLY 20 cc's!!!!!which is NOTHING!!!! The real issue is if you need lift?

Tom J. Pousti, MD · Answer

Good questions.  
Generally speaking, much of the final look and feel achieved after breast augmentation surgery depends on several factors:
1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants. Careful measurements (dimensional planning) and careful selection of breast implant size/profile are part of the surgeon's responsibilities.
I personally think that these 2 factors are more important than any others, including type (saline or silicone) or model (low/moderate/high profile) of implant.
3. The type of implant used may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. In other words, if a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
4. The size and model of breast implant used may make a significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon. 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 “big” or “D or DD cup” etc.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
I hope this, and the attached link (dedicated to breast augmentation concerns), helps. Best wishes.

Robert N. Young, MD, FACS (retired) · Answer

The difference in size is so minimal. You're looking at just over a single tablespoon! Most patients do better when they err on the side of going bigger in their decision between two sizes. Those that do not usually end up wishing they had gone bigger.  Given the photos you show that you like, I'd suggest considering Natrelle Inspira SRX would be the way to go. It will give you the projection and shape you're desiring. The photos shown also look like you may want to consider implants larger than 500cc in order to get that look. Most women report that using the new silicone gel implants produces very natural feeling breasts.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.  The implants that you have chosen are quite large and should achieve  a similar size to your desired photos.  All FDA approved breast implants are good implants.  At a recent international meeting of plastic surgeons a survey was taken and 83% of the surgeons present used smooth  round silicone gel breast implants.

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