Will round cohesive gel implants cause "stuck on" look like overfilled saline implants will on slender patients? (photos)

I have Sientra classic teardrop implants and want a revision to go larger. I am interested in round cohesive gel due to lower rupture rates but afraid of having the stuck on, too round look in the upper pole. Will this type of implant cause the unnatural look? I am 5'6, 121 lbs and a deflated A cup after breastfeeding two children. I had breast aug surgery July 2016 and have 310 and 350cc Sientra classic teardrop implants. I would like to be a full C, small D. Thank you for your time and input!

Doctor Answers 4

Can Cohesive Gel Implants Cause the "Stuck On" Look?

First of all, you are very early in the post op period to be overly critical about your result. The "droopiness that you point out may very well fill out over the next couple of months as your implant settles. Also, the incomplete filling of the skin envelope has more to do with the implant size and position and vesus the style or shape of the implant. In fact, the Sientra classic teardrop shaped implant will actually do a better job at filling out the lower pole of your breast because more of the implant volume is concentrated in the lower pole.

As a rule, any gel implant will provide you with a more natural, less "stuck on" sort of look compared to a properly filled saline implant. Saline implants "project" through your tissues more, and if your tissues are thin then they tend to look very unnatural. If you have very little tissue then a round cohesive gel implant can also look unnatural, particularly if it is a larger implant. For the person with thin tissues the teardrop shaped will provide a more natural look without the rounded upper pole that can be seen with round cohesive gels. Also there is no increased rupture rate occurrence with the shaped implants.

Kirkland Plastic Surgeon
4.8 out of 5 stars 52 reviews

Shaped versus Round

Hello,The dent in your photo is a double bubble, which won't be improved by switching to round, but instead by adjustment of the pocket.  It is still early in your recovery, and your implant may settle further to help round out that part of your inframammary fold . You should not worry about differences in rupture rates they are virtually the same. 
Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

Will round cohesive gel implants cause "stuck on" look like overfilled saline implants will on slender patients?

Round cohesive gel implants will not necessarily give an unnatural appearance if they are sized conservatively. If your initial augmentation surgery was only performed last month, I would wait until at least six months before you decide whether to have another surgery. With more time you may find that you are very happy with your current results. Also, your appearance will change in the next several months as your breast adjusts to the new implant.

Austin Hayes, MD
Portland Plastic Surgeon
5.0 out of 5 stars 32 reviews

Will round cohesive gel implants cause "stuck on" look like overfilled saline implants will on slender patients?

No, the use of round, silicone gel breast implants will not necessarily create an "unnatural look";  on the contrary, careful selection of  the appropriate round silicone gel breast implant (size/profile) and careful execution of the procedure can lead to a very nice and "natural" look.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. 
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or  "full C, small D cup" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice. 

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with. 

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

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.