Xtra smooth or regular smooth? Is there high chance for my petite frame to get rippling with regular smooth high profile?

Xtra smooth moderate profile implants produce just as natural a look as the regular smooth moderate profile implants.  The Xtra implants, however, have less chance having wrinkles due to the implant.  The Xtra Mentor moderate implants are idea for the athletic build or someone who does not have much breast tissue of their own. The choice of using the high profile implant, whether Xtra or regular, depends on the final size you desire to go to and the width of your breast base.  A narrow chest width my require high profile implants which have a narrower base. Dr. B.

Hello,
Your surgeon is recommending a ball shaped implant to give you the most volume. This recommendation is based on wanting to give you the biggest implant possible, but relies on incomplete biodimensional analysis that only looks at breast base width, and not more important criteria like tissue stretch and nipple to fold distance. You will end up looking like you have balls on your chest, and also rippling. You may be a good candidate for appropriately sized (likely smaller) shaped and textured implants. Go visit a few ABPS certified/ASAPS member surgeons who specialize in breast surgery and is experienced in shaped devices. 

The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Dear Girl_123,
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

the Xtra will do that for you... and it also has less rippling but it doesn't stop traction rippling (you see them when bent over at your waist 90 degrees).  If you want more natural, avoid the Xtra... but if you want fake, then you're on course to get that.

Thank you for the question.  Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical. 
 I have found the use of "higher profile" breast implants very helpful when it comes to achieving very nice outcomes for patients with small frames. Many of these patients, despite their very small frames, do wish to achieve a relatively full look (relatively large volume for their small frames). In these cases,  a well executed procedure and selection of appropriate breast implant size/profile is not necessarily associated with more "negative outcomes" than the use of lower profile breast implants.
 On the other hand, every patient undergoing breast augmentation surgery should understand that their anatomic starting point will limit the outcome of breast augmentation surgery.    In other words, a patient's starting anatomy will limit how large of a breast implant can be utilized safely. The use of a larger breast implant(than what is safely "allowed" by the patient's anatomy) can be problematic;  potential problems include breast implant displacement/malpostion issues ( such as bottoming out, lateral displacement, symmastia...)  and/or significant breast implant rippling/palpability.Generally speaking, palpability and rippling of breast implants may be related to several factors. These include the amount of soft tissue and breast tissue coverage over the breast implants, the position of the breast implants (submuscular versus sub glandular), the type of implants (saline versus silicone), and the degree of overfilling of saline filled implants. Generally, weight loss will extension weight any rippling/palpability of the implants.  ***Given your concerns, I would suggest that you schedule additional time to spend with your plastic surgeon communicating your goals, preferably prior to the date of surgery.
I hope this helps. Best wishes. 

The less breast tissue you have, the greater possibility of visible rippling regardless of the type of gel implants you have. The newest generation of Mentor memory gel implants tend to have very minimal rippling regardless of the profile use as the gel is quite cohesive and maintains a round shape. I use the mentor breast sizing kit and different implant profile sizes in my office to help a patient choose which size and profile would give them the best real-time appearance in their own clothes.  I personally find that the profile affects the amount of fullness and projection more than it does rippling and therefore in your case, you may consider also asking if the moderate plus styles would be a reasonable option. Hope this helps!
Johnson C. Lee, MD
Board-Certified Plastic Surgeon

Choosing the profile, type of implant, and reducing the risk of rippling are based on several factors.  The measurements of your breast width, your skin pliability, and the volume that you desire all play a role in choosing the profile of implant, so it is important that you are examined by a board certified plastic surgeon so he or she can guide you.  We use a mentor sizing system in our office to help with your decision as far as volume.  If you have very little breast tissue you do have a higher risk of developing rippling.  Placing the implant bellow the muscle will reduce the risk of this occurring regardless of which implant you go with.  That being said you are correct that a Mentor memory gel Xtra will give you a little more projection but also reduce the risk of rippling to some extent.  Your surgeon can go over the details of what the various projections you can expect for any given implant.  You can also ask them if they have any before and after photographs of patients with similar body types choosing the same implant.  Mentors website also has before and after photos that you can search by implant type which may provide some insight as to what you might expect (Mentor Gallery).  Obviously no outcome is guaranteed and everybody's body type is somewhat different.  Good luck with your surgery and enjoy!