What implant is best for dual plane?! Natrelle Soft Touch or Responsive? 325 cc or 395cc?

Is it best to use a cohesive round implant (TSR - Natrelle Soft Touch) or a cohesive responsive implant (TFR Natrelle unstable) for a dual plane BA? Also is it better to go bigger because dual plane makes the implant smaller? I'm torn between 295cc or 325cc. I want to look natural. Currently 32A petite, 5 feet. Please help! BA is in 2 weeks!

Doctor Answers 5

I think there would be very little discernible difference in comparison between these two implants in a dual plane

There are good things about all implant types and not-so-good things, and with the Allergan lineup of implants, I personally think one of the not-so-good things is that in an effort to create a more "customized" product line, they have actually made things a bit more confusing for people than they should be.  They have introduced a stunning number of different sizes, shapes, and variations of gel types, which on the surface may make their implants more appealing by offering more options, but in reality I don't think those options are always that detectably different once in the body, so the value of having so many options is questionable.  The intent with the Natrelle Soft Touch versus Responsive gels was to create two different levels of firmness in the same basic type of gel.  Both of those gels are what we call 4th generation cohesive gel, so that means both are more or less a solid as opposed to a liquid.  The Soft Touch gel is made just a tiny bit firmer than the Responsive, which is supposed to be softer.  This is intended to make the Soft Touch implants behave more like a true "gummy bear," or highly cohesive 5th generation gel and maintain their shape and projection height just a bit better than the Responsive gel, which is supposed to be softer.  The fact is that both are the same generation of gel, meaning cohesive, and neither is a true "gummy bear."  Thus, the difference between them, while more obvious when sitting on a table top, is not really that easy to tell for most people once they are in the body.  I think the bigger selling feature for the Soft Touch implants is that with the Inspira line, the fill volume is a bit more, so the projection height and stability is a bit more.  That's about it in my opinion.  Thus, I would wager that you would most likely not be able to tell a huge difference between either of those gels once in your body.  It's sort of like fretting over a 25 cc difference in implant size.  The number is clearly different, and people lose sleep all the time about differences this small, but if you asked most surgeons I think that they would tell you that most people can't tell the difference in breast size with such small volume differences.  You would be able to tell the difference in an Allergan 410 anatomical shaped gel implant though, as that is a true highly cohesive "gummy bear" gel implant, and the stiffest one on the market at that.

As far as the issue of implant placement is concerned, I personally don't think a properly performed dual plane placement would be any different than a properly performed submuscular placement as far as being able to see the implant shape or the feel of the implant.  That is because both dual plane and submuscular placement have muscle coverage at the upper pole of the breast, so they will be very similar in that regard.  I also don't think dual plane makes an implant "smaller" than a submuscular placement, as again, they are both in reality submuscular placements.  I think the thing that a dual plane really does is release the breast tissue attachments on the lower part of the breast from the muscle which allows the implant to both be placed under the muscle above, while at the same time fully expand the breast envelope below, creating a nice, full shape to the lower breast.  I would argue that done properly, this might even make the breast appear fuller, at least at the lower pole, where most people really want it.  Upper pole fullness is important too, to be sure, but the studies that look at aesthetics of the breast still suggest that 55% of the breast volume should be below the nipple, and 45% should be above.  So, a nice full lower pole is important and looks the best in my opinion.  This can be especially important for ladies with a bit of ptosis, or laxity, at the bottom of the breast because it helps avoid "Snoopy breast," too.  I pretty much do dual plane to some degree on ALL of my breast augmentations, regardless of implant type, and I believe it helps with accuracy of implant placement and the production of the most natural, smooth appearing results.

Depending upon just what you mean by wanting to "look natural," and the fact that you are so petite with what sounds like very small natural breasts, you might want to consider an anatomically shaped implant.  In my opinion, for smaller ladies like you seem to be, they provide the most natural appearing results.  This of course is a decision that can only be made after detailed personal conversation about goals and expected results and a careful physical examination.  I suggest you discuss your specific goals carefully with your surgeon and get full clarity on things before you go forward with surgery.  Don't feel that you have to proceed with a plan you are uncomfortable with or uncertain about just because you are "on the schedule."  If you aren't satisfied with the explanations that you get from your current surgeon, sometimes a second opinion can help by offering a slightly different viewpoint and way of explaining things.  Good luck.

San Diego Plastic Surgeon
4.9 out of 5 stars 87 reviews

What implant is best for dual plane?! Natrelle Soft Touch or Responsive? 325 cc or 395cc?

Thank you for your question. 325cc -395cc implants are too large for a woman of your frame. A dual plane approach simply means that your PS needs to cut the muscle to accommodate an implant >250cc for your petite frame. Once the muscle is cut, it permits the implant to become displaced laterally over time. This means that the muscle will eventually squeeze the implant out from underneath the muscle causing the implants to appear too far apart (to the sides). So, cohesive or not, it won't matter. The larger the implant the heavier it becomes - the faster they will make their way out of their pocket. So, choosing a larger implant will not help - it will make stretch deformities worse. I recommend you choose a smaller implant that will fit completely under the muscle for complete support to keep the implants in place long term.
I hope this helps.
Best wishes and kind regards,

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 222 reviews

What implant is best for dual plane?! Natrelle Soft Touch or Responsive? 325 cc or 395cc?

Thank you for your question.  Congratulations on deciding to go through breast augmentation!  Determining the "right" implant is a process with many factors involved.  In my practice, measurements are made of the breast dimensions to provide an initial guide.  My patients then try on different sizers within a normal bra while wearing a tight t-shirt in order to get a better idea of the look they want.  Also, having pics of other breasts that you wish to look like can aid the communication process.  Don't be fixated on a particular cup size or volume but try to determine the implant that gives you the best look.  In terms of implants, there are many great implants out there.  Silicone implants generally feel more natural although now, there is a new FDA approved implant called the IDEAL implant that feels natural like a silicone implant but has the reassurance of being a saline implant - you don't have to worry about silent ruptures or getting follow up MRIs every couple of years as you would with silicone implants.  Be sure to consult with an experienced plastic surgeon certified by the American Board of Plastic Surgery.  Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

Breast Augmentation

Focus on the look not the cc or cup size. Patient's often regret decisions based on extraneous factors as you may end up with suboptimal result. Bra's vary from store to store, and cc's mean nothing in isolation. You should be measured during your consult and offered implants within a 5mm window of those measurements in multiple styles. For what's its worth, in my experience a dimensionally sound mod+ profile tends to go from an A+/B- to the magical full C or small D. A high profile (or SRF) would be about 100ccs larger to maintain the same base width and more like a Full D but VS will call it a DD or DDD, particularly in a 32-34. Ultimately, try on the different styles and look in the mirror. When you see the look you like, pick that style! This requires a consult, exam, measurements and sizing with a board certified plastic surgeon. My patients select the implant style and their chest dimensions dictate the number of cc's. I make specific recommendations to each and every of the augmentation patients I see annually based on: 1) dimensional planning 2) expressed goals 3) amount and quality of tissue to hide the implant. I have included a link with my explanation of the different implants and what to expect from your consult as well as hundreds of before and after photos to see what change implants of a particular size deliver. Best of luck. #drfeldman #BancroftFeldman #breastaugmentation #sugarland #HoustonTX

Evan Feldman, MD, FACS
Texas Plastic Surgeon
5.0 out of 5 stars 86 reviews

What implant is best for dual plane?! Natrelle Soft Touch or Responsive? 325 cc or 395cc?

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.
Having said that, for most patients with your petite frame and anatomic starting point, I recommend the use of round silicone breast implants placed in the sub muscular (dual plane) position.  

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 we have time for a you their stuff's's homewith 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 know words such as “natural” or "C 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 for petite patients) 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.