Mentor silicone memory gel high profile 300-350 with lift OR no lift with Mentor cohesive gel/gummy bear non FDA approved?

I am really struggling with getting a lift or not.. I don't want the scars as I already have a TT scar and just don't want more.. But if I go through the surgery I want to look perfect. So what should I do?? One doc says no lift with non FDA approved textured gummy bears and the other days memory gel with lift. I have heard that the CG feels like rocks and are really only good for reconstruction.,, but are they worth not having the scars?? Please advise on your opinion!! Thank you in advance!!

Doctor Answers 10

Augmentation with or without Lift?

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It is impossible to give you a definitive answer without seeing you in person, but your photos do not seem to indicate that a lift would be necessary. Your nipple position is not significantly lowered and while you do have some glandular ptosis, and a stretched skin envelope, those issues should be correctable with an appropriate implant. 

All of the implant manufacturers, Mentor, Allergan, and Sientra have FDA approved shaped or form stable implants available on the US market. The term "gummy bear" is not accurate and gives the wrong impression. It is true that the shaped implants tend to feel more firm because the gel is more "cohesive", which allows them to hold their shape. They are useful in both reconstruction and augmentation. You should certainly avoid any implant which is not FDA approved, as there is not sufficient data to document their safety and efficacy. 

The Sientra shaped implants are the softest of the shaped implants available in the US and have been shown to give good results in the borderline lift patient. Sientra is also the only company that has a warranty that covers capsular contracture for the first year, so this could be an option to consider. 

Mentor silicone memory gel high profile 300-350 with lift OR no lift with Mentor cohesive gel/gummy bear non FDA approved?

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Thank you for the question and pictures. Although it is difficult to give you precise advise after viewing pictures only, it is probable that you will do well with breast augmentation surgery only, without the need for breast lifting.

 Be careful about achieving realistic expectations prior to  undergoing surgery;  keep in mind that it is rare for the breast to look “perfect” regardless of what exactly what procedure is performed.

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're 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 which operation and/or 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. I have found that the use of words such as “natural” 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 who makes the bra; therefore, discussing desired cup size may also be inaccurate.

The use of computer imaging may also be helpful during this communication process.

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.

I hope this, and the attached link, helps.

Breast lift or not??

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You do not need a lift as your nipples are above the creases and pointing forward. But you do have a very empty skin envelope and might need to consider a higher profile style implant to fill it out. Gummy bears vs cohesive gels make no difference in the lifting issue, most times the softer feel is better.

Lift or no

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From the photos, your nipples look like they are in a good position. You do have a bit of glandular ptosis.  Best to be seen in person, you may not need a lift.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Lift or not

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Thank you for the photos and from them I would say you do not need a lift and do not need the the textured anatomical implants to get the result that you would like. If your nipple is at or above the inframammary crease (which your's is) you do not need a lift.  Find a board certified PS or surgeons in your area who is a breast expert.

Dr. Corbin 

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 65 reviews

Breast Augmentation with Mini Ultimate Breast Lift(TM)

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I recommend a new technique called Breast Augmentation with Mini Ultimate Breast LiftTM. Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Through the same incision, implants can be placed. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant. Small round textured silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Implant profile is irrelevant in the retro-pectoral position since the muscle compresses it. This technique avoids the ugly vertical scars that women find unacceptable while maintaining nipple sensation and the ability to breast feed. I believe 300-350 cc implants would be too large, will extrude inferiorly and laterally requiring revision. 22% of women who undergo breast augmentation alone require revision within 2 years because of they are dissatisfied with the final result.

Best Wishes,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

To lift or not

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I think you will be fine without the lift.  Implants of the size range you mention I think will give you a quite nice result.  The decision to use saline or silicone is up to you. The gardening you mention may refer to capsular contracture which is one of te risks of breast augmentation.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 31 reviews

Breast lift or augmentation

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Thank you for the pictures.

In my opinion I don´t think a lift is needed. Your nipples seem to be in the right position. I do recommend an implant placement to enhance and create volume. Cohesive gel and gummy bears are the same thing, the cohesivity of the implant to make it softer or firmer it´s the difference. I would suggest a softer one for more natural touch.

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 257 reviews

Lift or no lift with breast augmentation?

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Thanks for your question.  Let's start with a few things.  I don't mean to contradict something you have heard from other surgeons but all of the "gummy bear" implants are FDA approved at this point.  A number of companies offer various types of this same implant material but all are now fully approved.  Looking at your photos, your side profile clearly shows that your nipple/areolar position is above your inframammary fold.  Based on this I would say that you don't need a lift.  However, the lift question also is based on what "look" you want at the end of the process.  If you want a very high full look then you may need at least a small lift (i.e. a peri-areolar lift).  If you want a more natural look then I don't believe you need any type of a lift with your current position.  The same is true with the implant.  If you want more fullness in the upper portion of your breast then do not go with a gummy bear implant because they won't give you this type of look.  Hope this helps.

Shaun Parson, MD
Phoenix Plastic Surgeon
4.8 out of 5 stars 47 reviews

Hard to say for sure

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jnay:  It's really hard to tell for sure in your case whether you need a breast lift or not.  You appear to be borderline and a careful exam is mandatory before giving an opinion but my hunch is that you will be fine without a lift.
The implant material is a sepearate issue.  All silicone implants sold in the US are FDA approved for women 22 years and older, and all current silicone implants are cohesinve. They are the most natural feeling implants currently available.  If they feel hard in some cass that is generally a matter of scar contracture around the implant and not an issue with the implant itself.
Good luck to you!

G. Robert Meger, MD
Phoenix Plastic Surgeon
4.9 out of 5 stars 96 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.