Breast implant decisions. Which implant do you consider to be the best made and the safest?
Doctor Answers 6
Thanks for your question. There truly is no best implant. Gummy bear and round implants are both silicone gel. The gummy bears are just more cohesive. They are a nice implant but I personally don't think the advantages for most patients are worth the extra cost. But for you hose patients who really want them I do but them in. There are a few unique complications associated with gummy bear implants; rotational deformities, later forming seroma's and due to the texturing ALCL. ALCL is a very rare form of leukemia thought to be associated with textured breast implants.
While there are many women happy with their shaped gummy bear implants, I know many many more happy with the round implants. Good luck I am sure you will be very happy with your results regardless of which device you use.
John S Mancoll,MD
Choosing the right implant
Hello and thank you for your question. Gummy bear implants may refer to different types of implants. Sometimes people refer to anatomic implants such as the Allergan 410 as gummy bear implants or they could just be referring to the memory gel implant. My point is that gummy bear implants are a loose term and not one specific type of implant. The implant you choose should be based on your desired shape and size, your chest dimensions and whether you want anatomic implants or round implants. A discussion between you and your surgeon is an essential part of this process. Make sure that you seek a consultation with a board certified plastic surgeon that has done many augmentation procedures. Best of luck with your upcoming surgery
Hello and thank you for your question. 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. This entire surgery can be performed with a small incision technique. 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.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon
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Which implant is the best?
It is very difficult to determine the best lift 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 implants
Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery
I appreciate your question.
The size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve. If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.
Silicone will give you a fullness at the top (upper pole fullness).
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.
Anatomic gummy bear implants might be a good choice to give you volume.
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.
The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
Best of luck!
Board Certified Plastic Surgeon
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.