225, 250, 275 Mentor cohesive silicone implants? What should I do? (photos)

Question

I'm petite and I want something proportional to my body. I just want to be conservative with my breast tissues to avoid capsular contracture. I have gone to 3 consults so far. 1st dr said 300cc, mod. Plus profile, under m. 2nd, 400 cc, mod. prof, under m. 3rd, 250 or 275cc, high prof, under m. I'm 35 years old, no kids, 5'5", 98 pounds, one do the doctors told me that he has 10.4 to fit the base of the implant in my breast pocket. What size should I choose???

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

#RealSelf100Surgeon

#RealSelfCORESurgeon

Donald Groves, MD · Answer

Hello and thank you for your question. Honestly, a formal in-person evaluation would be needed to determine the best treatment. There are several reasons for this: 
1) Bra sizes vary based on the clothing store (for example, Victoria's Secret tends to upsize everyone by a whole cup size)
2) Most women do not wear the proper exact fitting bra size for their bodies
3) The exact volume (in cc) needed to change cup size is different for different body types (e.g. 32A to 32D requires a different implant size than 38A to 38D)
4) Be careful NOT to fall into the trap most women do- they see a certain implant size (e.g. 285 cc) or perhaps their friend had a certain size, and they want or request this or another size based on that. Everyone's body is different- 285 cc implants on your friend might look VERY different than they would on you. Be very careful not to make this mistake, because the goal is to find the right size and shape for YOU- for your particular body and your breasts.

Because of those multiple factors, and because it is KEY to fully evaluate your breasts in person to make a full set of precise measurements to select the proper implant for you (incorporating factors like amount of breast tissue, implant type, base width, projection, etc), answering your question really would need a formal personalized consultation- to say anything before that would simply be guessing, which would be both unfair and unhelpful to you. Also, just FYI, each surgeon's measurements are slightly different, so numbers, experience, and overall aesthetic from one surgeon aren't necessarily the same as those from another surgeon!

Your breasts are such a KEY area of your body and your femininity- therefore, you should ONLY trust an experienced aesthetic plastic surgeon. As such an expert, I have had extensive training and experience with complex aesthetic surgeries under a multiple world-renowned experts in the field. I’d recommend for you to setup a formal consultation with me (or another plastic surgeon who is extremely comfortable with aesthetic plastic surgery procedures) for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case.

I'm located right here in Los Angeles. I hope this helps!

Dr. Donald Groves
Aesthetic Plastic Surgeon

Aldo Guerra, MD · Answer

Hello Petite. There's no way to give you specific size advice without an examination. Tissue based planning and good communication with your plastic surgeon is the best way to achieve your goals. With your BMI, you're at risk of rippling so avoid a textured device. In the past, 250-300 has resulted in B/C cup range for my patients, but I cannot predict just what it will do for you.

Warmest regards, Dr. ALDO

Warmest regards, Dr. ALDO

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. 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 breast surgery. Hope this helps and good luck with your surgery.

Milind K. Ambe, MD · Answer

Thank you for your question and photos.  Due to your small frame a high profile implant might not be a bad idea since you seem to have a narrow chest wall.  I would recommend more like 275-300cc size but that is based on pictures alone.  If you are still uncertain then I recommend seeing some board certified plastic surgeons in your area for some more opinions.  Best of luck to you

Curtis Wong, MD · Answer

to get a fuller result... but you also have to be careful when doing that.  Find the look you want with external sizer and let your surgeon pick the best profile to match that size to give you the look you want.

Tom J. Pousti, MD · Answer

Thank you for the question. Based on your photographs, I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery.  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.  You will find many similar/representative examples on the attached link.

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 know words such as “natural” or "C cup” or "proportionate" 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.

Christopher Costanzo, MD (retired) · Answer

There is no accurate answer for you.  225cc is very small, but 275 to 300cc would probably be a better choice for you.  In my practice I find that most women with your proportions look best with a high profile implant.  I always ask patients to show me photos of how full they want to be by showing other breast augmentations patient whose results they like.

225, 250, 275 Mentor cohesive silicone implants? What should I do? (photos)

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