How much do I need to overfill a moderate round saline bag for "fake" looking breast implants? (Photos)

Question

I like the "fake" looking breast implants (very high on the chest frame, very round, lots up upper fullness). However, I like implants that are very round, especially since I have a wider chest frame. I'm afraid HP would be too narrow for my frame and I really like the round look. Would overfilled moderate round saline give me the "fake" look? How much would I need to overfill the bag by? I would like to be in the 550-650 range.

Larry S. Nichter, MD, MS, FACS · Answer

It is very difficult to determine the size you will need (recommended based on your photos) or the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 300 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. The same process goes for just filling in the upper part of your breast without becoming much larger. Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the link below including silicone vs saline implant
#toobig #breastimplant

Paul E. Chasan, MD, FACS · Answer

The problem with overfilling a saline implant is that saline implants are not dome shaped and as you fill them up the sides come up causing wrinkling and thinning of the tissues. If you want a fake look, the best option is to switch to Allergan's Inspira SRX ultra high profile silicone implant. It has the most overfill and projection while still maintaining a dome shape. Since you have implants currently, a capsulorrhaphy is often needed. You need to see a plastic surgeon who is very experienced at revisionary breast surgery to achieve your goals. Best of luck to you.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.   The size,
profile, and shape of the implant is based on your desired breast
size/shape, your chest wall measurements, and soft tissue quality. 
This decision should be based on a detailed discussion with
equal input from both you and your surgeon.   Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their
results.   The most important aspect is to find a surgeon you are
comfortable with. I recommend that you seek consultation with a qualified
board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

William Andrade, MD · Answer

Hello, although overfilling implants does tend to give them a rounder look, it could also void the warranty or make them more prone to rupture.  Perhaps your PS can find a different option.

Tom J. Pousti, MD · Answer

Thank you for the insightful question.  Much of the final outcome achieved with breast augmentation surgery depends on the patient's anatomic starting point.  In some ways, it may be more challenging to achieve an "fake look" when patients start out with a significant amount of native breast tissue.  Having said that, it is usually possible with careful dissection of breast implant pocket (I generally prefer the sub muscular pocket for most patients, including patients who are looking for a larger or more fake look)  and careful selection of appropriate breast implant type/size/profile to achieve the "fake" look.
 Generally speaking, patients attempting to achieve the "fake" look often benefit from the use of  higher profile silicone gel breast implants or overfilled saline filled breast implants.  
 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 “fake look” or "D or DD 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 "faker" breast augmentation surgery concerns) helps. Best wishes.

Arian Mowlavi, MD, FACS (license on probation) · Answer

you can overfill saline implants to their max, which I believe is 20cc above the stated fill volume on the implant; this will provide you a sharper upper pole without cancelling your warrantee on the implants.

Edward J. Domanskis, MD (in memoriam) · Answer

You can get the fake look by overfilling saline implants and/or XL breast tissue expanders.You can think of a saline implant as a balloon. The manufacturer recommends an overfill of about 20cc but they have been shown to be able to be filled much more than that. They do start loosing their shape and can significantly distort the appearance of your breasts. 
 I do overfill espcially since the FDA has restricted saline and silicone implants to a maximum saline shell size of 800cc and maximum silicone size of 800cc. I do not know why that number was picked arbitrarily. 
So, I do do breast reconstructions greater than that with XL tissue expanders which do pride a greater diameter and projection and upper pole fullness and allow the size to be adjusted either up or down. Also, the shell of the saline implants are very thin and can dreflate more easily. You may want to visit my site below which explains everything, esp for XL sizes which is my specialty, either initially or revisional surgery.

Ronald V. DeMars, MD (Retired) · Answer

Make sure you consult with an experienced surgeon who carefully explains your answer and also the downsides including stretched out and damaged skin that can't be corrected, chronic back pain., visible rippling (a very fake look), and increased risk of implant rupture and loss of manufacturer warranty coverage.

How much do I need to overfill a moderate round saline bag for "fake" looking breast implants? (Photos)

Answers (8)

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