Are the highly cohesive - Natrelle Inspira Cohesive too hard?

There are several things to consider for placement and selection of breast implants in athletic women. My first suggestion is do not do dual plane, as this detaches a portion of the pectoral muscle and weakens it. Split muscle might be an option but subfascial is probably best. Since this limits the coverage, a more cohesive implant will help minimize rippling. Feel a cohesive implant and see what you think, you might think they are OK. Don't go more than a moderate profile though.

patients have different expectations of both shape and firmness of implants. A firm implant can often and maintain better upper pole fullness. Being a weightlifter, there should be little concern for rupture between the various implants

Hello, the Inspira Cohesive line of implants (also called Truform III) is the newest smooth round silicone gel implant in the Inspira line, so to my knowledge there are no long-term studies demonstrating that is has a lower rupture rate than the Soft Touch (Truform II) or Responsive (Truform I) implants. Furthermore I do not think there are high-quality comparative studies demonstrating that they look very different in an actual patient. I think it is premature to conclude whether they are different from other implants in terms of their risks and cosmetic outcomes. That stated, the Cohesive style implants themselves certainly feel and look like they maintain their round shape more than previous implant generations, and to date I have not had a patient tell me they feel too firm in their body. Your best advice will come from full in-person consultation(s) because the look and feel of the implants in your body will depend on your physical characteristics, implant projection and width, breast pocket and other factors, not just the thickness of the gel within the implants.

Thanks for your question! The cohesiveness of the implant won’t dictate whether or not it ruptures. I only use the fully cohesive implant on very thin, fit patients that don’t have any body fat or breast tissue to cover the implant. That way, they have the least amount of rippling. Talk to your surgeon about your goals to ensure you guys are on the same page. Good luck!

Dear Peaceful9125,
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

I appreciate your concerns, however your surgeon does make a good point with regard to the highly cohesive Natrelle implant. It is a bit firm and usually recommended for breast reconstruction after cancer. The lifespan of all of the latest generation silicone implants are essentially the same and not affected by the degree of cohesive silicone. Also the fact that you are a weightlifter does not affect longevity of implants either. Discuss all your concerns with your board-certified plastic surgeon. Good luck.

Both the responsive or soft and the cohesive style implants have the same silicone shell so they are both highly resistant to rupture. The cross-linking is different on the inside and will determine the firmness of the implant. You should ask to see the different types of implants so you can feel them for yourself and see which one you prefer. Hope this helps!

Johnson C. Lee, MD
Board-Certified Plastic Surgeon