Overfilling Natrelle 68MP 390cc

Some plastic surgeons believe that overfilling a saline implant will reduce the incidence of wrinkling and rippling. Other times an implant is overfilled just to achieve a little more volume. Limiting the amount to of overfill to 10% of the specified implant volume is probably a good rule of thumb for most situations. So for the implant you mention, 40cc would be about the maximum overfill. I just placed these implants the other day and planned to use them in the 400cc-420cc range. I increased the fill volume to 450cc because I thought the patient would appreciate the small increase in volume and projection that I achieved with that additional volume.

Overfilling an implant does come with a trade-off, namely implant firmness. The more a saline implant is over-filled, the firmer the consistency of the implant becomes. This is why overfilling is often limited to about 10% more than the specified volume of the implant. It allows overfilling without a significant increase in the firmness of the implant.

Different saline implant styles tolerate overfilling to different degrees. Moderate profile implants tolerate overfilling better than others because of the surface area–to–volume ratio of this implant design. If a surgeon wishes to push the amount of overfill above the 10% rule of thumb, it is easier to do this with a moderate profile implant. High profile implants, with a smaller surface area-to-volume ratio, do not tolerate overfilling to the same extent; and it is my preference not to overfill these implants beyond the specified volume. Contoured (anatomical) implants do not overfill well, also. As a contoured implant is overfilled, it begins to lose its shape and more expansion of the upper pole occurs.

I hope your surgery went well.

Dear Bebelici0usz in Honolulu, HI:

The term overfilling is leftover from an era when implants came labelled with a single volume. For example a surgeon would take a 300cc saline implant and routinely fill it to 330cc (an overfill of 10%) because the implant rippled less and felt better.

Since that time the FDA has demanded a specific volume range from implant manufactures. For the example of the 300 cc implant given above, the same implant (moderate profile because that was the only profile available then) no comes labelled as a 300-330 cc implant. FIlling to the upper volume is the same as overfilling the 300 cc implant by 10%.

Implants can be filled greater then the suggested; however this is an off label use, and technically violates your implant's warranty. Overfilling leads to increased projection and stiffness, and can cause scalloping (wrinkling) of the implant around the edge. While overfilling is rarely advantageous, underfilling is always wrong. An underfilled implant will wrinkle more and will deflate more often.

It sounds like you still have some confusion regarding your surgery tomorrow. You should call you surgeon today.

Hello,

Overfilling implants by 10% can mean whatever the surgeon wants it to mean; there is no standardization.  My recommendation is that you clarify with your surgeon what exactly is his criteria for filling breast implants.  Saline filled breast implants have the best shape, softness, and least palpable rippling right about at the top of the recommended fill, with a margin for overfilling another 5 to 10 cc.   For example, a Natrelle 68MP 390cc implant will do best at 420cc, but will still be fine at 430cc.  Beyond this, the implant begins to loose its shape, develop more rippling, and become firm.  'Pressure atropy' and 'water hammer' effects are more prominent in an overfilled saline implant too, causing long term changes (thinning and stretching) of your body tissues, as well.

Regarding your choice of implant size, the 390 is too big for you.  This implant will ripple on you, something that you will feel and may even see (those tiger stripe-like marks on the sides of the breast) after you heal from your surgery.  If you insist on this size, you will do better with silicone gel filled implants.  I would still consider a smaller implant though.

Best of luck!

Saline implants can be filled from the minimum to the maximum manufacturer recommended volume, or in your case from 390 to 420ccs.  Overfilling the implant beyond the maximum recommended volume is not recommended and may void the manufacturer's warranty.

The implants you described can be filled up to 420 cc's.  Some surgeons overfill( above the 420) to avoid rippling but it may make the implants a bitr firmer. As for the voiding of the warranty, you would have to ask the implant company.

"Overfilling" is a left-over terminology when Breast implants came in with a single set volume. In those days, many surgeons routinely put 10% more of the labeled volume into those OLD saline breast implants to make sure the implant shell was fully expanded. A fully distended shell, one with less waviness, lasts longer and develops leaks much later than a implant whose shell is loose.

Mild overfilling of the implants resulted in stiffer but smoother walled implants. Putting in much more than 10% of overfilling resulted in VERY tight implants with scalloped hard folds along the rim of the implant. Since the "stiff" look was not very attractive to the touch, to combat it some surgeons would purposefully "under-fill" the implants. While these implants were definitely softer they also deflated much more frequently owing to the breaks caused by the repeated in-folding and out-folding of the loose, under-filled implant shell.

All of this is part of breast implant history. Today's newer saline implants (such as the Mentor series 2000 Moderate Plus implants) come with a RANGE of suggested fill volumes and are engineered to look attractive to ANY fill within that range. If your Plastic surgeon uses such implants, the discussion of Overfilling need not be had.

Good Luck.

Dr. Peter A Aldea

The term overfilling was really used when you had a 275cc implant for example and could be filled to 300cc. That would be overfilling. MY impression would be that over filled would be 430. More than that will violate the implant warranty

The Natrelle implants have a fill range and it is true that many surgeons fill to the top of the range as under-filling can cause premature wear of the implant. Overfilling is another issue and we do not believe that many surgeons really overfill above the manufacturer's fill range, nor is there any reason to do so. The implant will stiffen when over filled, and develop static ripples along the implant edges. You better ask your surgeon just what the '10%' is all about.

Best of luck.

peterejohnsonmd

The manufacture of the Natrelle saline implant leaves the fill volume up to the surgeon.  However, it is suggested that an overfill, up to 30'cc, is done.  This will make rippling and folds more difficult.  Also, the longevity of the implant may increase as there is less folding and rubbing of the shell, that houses the saline.  I hope this helps.

Today it's rather clear that "underfilling" a saline implant means filling it below it's rated fill volume. "Overfilling" means filling a saline implant above its rated maximum fill volume. In general it seems that underfilling or overfilling saline implants leads to an increased risk of visible or palpable ripples, may contribute to early failure of the implant, and is not following the manufacturer's specs for the implant. Usually this fill range is within 10 % of the rated or minimum fill level. For a Natrelle Style 68 implant rated at 390, the maximum I would fill it is to 430 cc's. Mentor saline implants have a fill range that sometimes exceeds 10 % but there is really no reason to exceed it when other implant volume options are available.