Motiva Ergonomix or Round? (Photo)

Question

Hello,I will have a breast augmentation operation.450 cc motiva is suggested by my doc. I want both natural,sexy but also not fake image.What shape would be better for my body type?Round or anatomic?

Terrence Scamp, MBBS, FRACS · Answer

Hello there 
I was under the impression Motiva weren't yet available in the USA .
However I have been using them for a year now and I think that the Ergonomix is a great balance in that it falls to your breast shape and looks very real , like an anatomical implant . But you can 'push' it with a bra and make it look quite round .
And it has no risk of rotation and it is a very soft but strong implant with a lot of clever science in the implant wall design .
So it has become my implant of choice .
Cheers
TS

Ted Eisenberg, DO, FACOS, FAACS · Answer

I recommend round smooth implants for a more natural look. After my patients discuss their goals, I measure them.  Then we look at pictures of women with similar measurements with different size breast implants. This process has been very satisfactory in giving patients a good sense of what can be accomplished.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

Urmen Desai, MD, MPH, FACS · Answer

I recommend smooth round implants.  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

Gerald Minniti, MD, FACS · Answer

Hello,I can tell you that the vast majority (90% plus) of American plastic surgeons have never used, and will never want to use shaped implants. The reason is this: there has been a loud, vocal back lash to these devices by a few academic surgeons on the lecture circuit who have made these arguments:1. Shaped implants are evil, they rotate. More complications!2. They look the same as round implants, nobody can tell the difference!3. They don't have the same upper pole fullness, American women want more of that, not less!As you can see, #3 contradicts #2, but I've heard both come out of the mouth of a lecturer in the same lecture! What does the data tell us? Shaped devices do have a unique risk that round don't have, rotation. However, that rate in the hands of experienced surgeons is about 1-2%. Most importantly, the overall complication rate is LOWER than round smooth devices. This have been demonstrated in many studies. Finally, the truth about appearance is that in certain individuals, shaped implants will give a more natural appearance.  I have been using shaped implants since 2012 and find them to be better devices with less complications than round. Best of luck!

Daniel Barrett, MD · Answer

Dear selena80,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, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Jordan P. Farkas, MD · Answer

I usually use round implants for breast augmentation as anatomic implants have not shown to have any discernible advantage and can have the potential to rotate. Discuss the pluses and minuses with your surgeon to find out the best implant for you. Good Luck!

Luis E. Redondo, MD · Answer

Motiva ergonomix is a round implant as well, and one that I have started to love do to the natural feeling and softness that it gives. That would be a good choice.

Tom J. Pousti, MD · Answer

Thank you for the question. I think that you are starting at a good place and should have a very nice outcome with breast augmentation surgery, assuming you choose your plastic surgeon carefully and communicate your goals carefully as well. 
These days there are a variety of breast implants available; the variety of breast implant available raise a lot of questions from women considering breast augmentation surgery. Personally, I think that for most patients considering breast augmentation surgery, careful selection of plastic surgeon and careful communication of goals, far outweigh the specific type of breast implant utilized (when it comes to the success of the breast augmentation procedure).
Anatomical breast implants were designed to better simulate the natural breast shape; the problem with these implants is that if they shift or rotate, the entire breast will change shape as well. This change in breast shape may require further surgery to correct. Round implants, under the hand, can shift or rotate without changing the shape of the breasts. ***Overall, I find that beautiful outcomes can be achieved with the use of round saline or silicone gel breast implants for the vast majority of patients.
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 fake look” or "C or 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 helps. Best wishes for an outcome that you will be very pleased with.

Jon A. Perlman, MD (retired) · Answer

Thank you for your question.  The majority of my patients want a noticeable change in their breast size but want to maintain a natural look.  I've had great success over many years using round smooth partial subpectoral breast implants with the advice that the most important thing is to avoid going excessively large for your soft tissue coverage.  I agree with the majority of surgeons who find that anatomic implants have little to offer when compared to round implants but feel that they do provide good results in the majority of patients.  At a meeting of board-certified plastic surgeons in San Francisco several years ago, the audience of 200+ board-certified plastic surgeons were only successful in guessing 53% of time which patients had teardrop shaped or anatomic implants versus round implants, a very poor success record in my opinion.  If we could hardly guess which patient had anatomic implants versus round implants how significant could the difference be for patients?I would also be cautious in choosing your implant size so that your breasts are not overwhelmed by the volume of the 450 mL implants that you are considering.  My personal approach is to set size and contour goals with my patients and then determine the actual final implant size during the surgery when test implants called sizers are placed.  This allows me the greatest accuracy in determining the best combination of size, shape and contour obtained with different volume implants before making the final choice.  I prefer this method to stuffing a bra or choosing an implant solely based on dimensions.I would also say it's equally important to find a plastic surgeon who gives you the greatest sense of confidence based upon personal rapport and before-and-after patient photos.  This is of equal or greater importance than the actual technique or implant selected in my opinion.I hope this provides some helpful information for you.  I'd recommend that you watch the video link below about the selection of the best implants for my patients that you may find of interest.  Wishes,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd

William H. Jervis, MD, FACS (in memoriam) · Answer

of course gel filled are sometimes more natural visually ( rippling with saline ) and to palpate as well. consequently gels have captured 90% of the market.  anatomic implants are not really necessary as both salines and gels naturally "anatomicize" their shape in the upright position unless they develop contractures or are too large for the space. anatomic implants are also textured which I prefer never to use unless there is an overriding reason to do so. the critical issue is to to use a disposable sizing implant before you open the permanent implants which means using the sizer to determine what the implant looks like in place ( almost always subpectoral ).  that being done allows you modify the space and open the right size implants to put in.  if there is ptosis and or asymmetry it is also important to sit the patient up to almost 90 degree with the sizer in place and sometimes with the permanent implants in place.  saline sizers can be used  as intraoperative tissue expanders as well by overfilling up to 600 or 700 ccs for about 10 minutes to stretch the tissues so a larger implant can be used.

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