Natrelle 375cc Inspira TRX High Projection Implants? (photo)

Question

Having BA next week. Surgeon has said for me to have above implants. I am a 32a, petite ish frame, 5ft. Slightly worried such high projection implants will look too round / fake. They are being placed above muscle top half and below bottom half. Had a look at some before and after pics and I think this size is maybe too large, I did show surgeon pics of what I wanted to achieve and trust him, but had thought maybe mid / high profile would be better?

Jeffrey Rockmore, MD · Answer

Thank you for your question and the photo. The proper choice of implant is something that creates a fair amount of anxiety for women leading up to their breast augmentation. While there are no absolute right or wrong choices, I will give you my thoughts on the choice.

	Breasts always look mod natural after a breast augmentation if the implant choice is based on a three dimensional concept. The width of the implant should be matched to the desired width of your breast. The projection can then be determined based on the shape and fullness of the desired result. The volume becomes almost secondary. 

	I tend to use more moderate and moderate plus or midrange profile implants. I think that the high profile implants can make the breasts look overly conical and round - a more implanted look. It is impossible to determine the best implant size for you based on your pictures, but I would ask your surgeon about other implant options and express your concerns.

	Best of luck.

	Sincerely,

	Jeff Rockmore

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

I think you were wise to show photos of what you want to look like as it is very difficult to determine 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 350 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. . 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 below link:

Ziyad Hammoudeh, MD · Answer

Natrelle Inspira implants are round implants.  The width of your chest wall determines the range of implant widths that would be appropriate for you.  For any given width, there are various projections that will alter the volume of the implants you select.  Increasing profile/projection will increase volume, and decreasing profile/projection will decrease volume for a give implant width.  
If you have a narrow chest, as it seems from the petite frame you describe and your photo, then you should choose an implant width that does not exceed your chest width.  To achieve a larger volume augmentation such as 375 cc for your chest width, you have to increase the profile/projection.  Decreasing the implant profile/projection, as you suggested you may desire, will decrease the volume.  
The TRX designates that the Inspira implants are textured (T), responsive silicone gel (R), and extra high profile/projection (X).  Preoperative planning is an extremely important part of the consultation.  In our practice, we use Vectra 3D imaging, so that you can see exactly what 375 cc Inspira TRX implants would look like on your body.  This allows you to compare the extra high profile to moderate and high profile implants of the same base width.  This helps to ensure the best possible postoperative satisfaction with your implant choice.  If you have any concerns regarding the implants planned for your surgery, I would strongly recommend discussing your thoughts/concerns with your plastic surgeon prior to your surgery date so that appropriate changes regarding implant selection can be made if desired.
Ziyad Hammoudeh, MD

Josh Waltzman, MD, MBA · Answer

The appropriate size implant is a somewhat difficult question to address completely with just a picture.  There are a number of factors that go into selecting a safe implant that will provide you many years of satisfaction.  Many of the initial decisions regarding implant size are based off of measurements of your breast and chest.  As you start to increase projection you will start to get more of an unnatural appearing breast, or an augmented look.  If you have concerns about your implants I would schedule another consultation with your surgeon before your surgery to discuss your questions.  Best of luck!

Paul Gill, MD · Answer

Generally speaking, the bigger the implants, the higher the risk of complications.  In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements and characteristics.  Unfortunately, there is not a general rule of thumb or objective criteria to implant selection.

	Your plastic surgeon will perform several measurements of your chest wall and breast anatomy and determine a range of implants that both fit your chest wall and reach your desired goals.
	The next step is to try on this range of implants in the office with your doctor.   The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant.   It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you.
	I wish you a safe recovery and fantastic result.
	Dr. Gill

Darryl J. Blinski, MD · Answer

Thanks for the questions and before posted photo. You might be confused. The upper part is below the muscle not the lower part. I recommend the "new" Mentor ULTRA HIGH PROFILE in 300 cc range to 320 cc range.

Jourdan Gottlieb, MD · Answer

I generally find these extra high projecting implants to look unnatural. I only use them in a patient that wants to have really large implants that would otherwise be way to wide for her breast width. Without knowing your breast width this is a guess, but I would favor a smaller implant that is high or moderate plus profile. 

	 

	By the way, I would assume the upper part of the implant will be under the muscle, the lower half under the breast. 

	You should have another meeting with your surgeon and discuss. Thanks for your question, best wishes.

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