I hate these Natrelle 410cc's; I am regretting changing and wish I went with silicone rounds. How long should I wait? (Photos)

I previously had saline implants. Rippling and bottoming out after 7 years caused me to revise with Naterelle 410s. I hate them, still rippling and now I feel like I'll never be able to wear a normal bra again because they don't move. I don't know how long to wait before revising again. My plastic surgeon says that I'm too thin to fat Graft, but I'm 5'2" and 105-ish and I feel like there's enough fat to improve upon the rippling. He didn't think Strattice would be worth the expense.

Doctor Answers 9

Implant Rippling

I am surprised that you have rippling with the 410's because they are very firm. If you switch to round silicone you may still feel and/or see the folds of the implant because you are so thin. Yes, the 410 implants don't move and that is the trade-off to get a natural shape and you appear in the photo to have a very good cosmetic result. One thing that may improve this situation is if the implants are above the muscle, have your surgeon change them to a sub-muscular pocket for more soft tissue coverage.


Indianapolis Plastic Surgeon
5.0 out of 5 stars 94 reviews

Rippling

If your implants are above your muscle, which appears to be the case, there is very little you can do to hide the rippling. Fat grafting can help but you don't appear to have much extra fat. Overall I think your result is good and you may have to live with some degree of rippling given how thin you are 

David R. Alfonso, MD, FACS
Grand Rapids Plastic Surgeon
4.9 out of 5 stars 35 reviews

I hate these Natrelle shed breast implants. = Consider sientra round implants #breastimpants #gummybearimplants

In the world of silicone breast implants, there are two type of implants: round and shaped .

Shaped implants are the new type of implants that have a tear drop shape and give a "natural" shape to the implants. However,  the term "natural" doesn't mean that is what the patient in the United States wants.

In the US, most of the patient want to have a Pamela Anderson or nowadays Nicky Minaj or Sofia Vergara breast look: a lot of upper pole fullness, This is only achieved with round implants. The shaped implants, since they give an smooth transition from the chest to the breast, they don't give an upper pole fullness. 

Shape implants are common Europe. However, in the US they are not as popular since they don't deliver the type of breast shape the US patients wants. 

In my practice I recommend the brazilian gummy bear breast implants made by sientra. They come in both shape and round shape, but I only use round ones. They give excellent upper pole projection and they have minimal risk of rippling even in thin patients.

Patients interested in breast implant revision/exchange should  ideally wait at least 6 months to a year to undergo the procedure.

John Mesa, MD
New York Plastic Surgeon
4.9 out of 5 stars 110 reviews

Timing of revision surgery

Thank you for your question and photos.  I am sorry you are unhappy with your last procedure.  You will likely get different answers, but I think waiting about 6 months is reasonable.  You are thin, so you do want to confirm that your implants are under the muscle.  This will add tissue coverage along the upper breast.  Strattice, Alloderm, or Seri are all products that could potentially be utilized to add coverage over the implant.  You may wish to get a second opinion if your surgeon does not wish to consider a tissue product.  Also, fat grafting may be an option, but there is still some concern regarding the safety of fat for purely cosmetic purposes.  Good luck. 

Breast Implants / Breast Augmentation/ Breast Fat Transfer/ Cohesive Gel Implants / Silicone Implants / Revision Breast Surgery

Thank you for your question.

Best to wait 6 months to 1 year for a revision surgery.

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!

Dr. Schwartz
Board Certified Plastic Surgeon
Director-Beverly Hills Breast and Body Institute
#RealSelf100Surgeon


Time for a Revision

Thanks for your question and pictures.  I usually tell my patients at least 6 months to one year when looking for revision surgery.  As far as rippling, you would be better served to have the implant placed under the muscle if it isn't already.  And Strattice is worth the expense if it gets you the look you are hoping for.   This means that you like the way you look, you heal well, and can enjoy your implants for 10 years plus.  

Wishing you all the best,
Steven Camp MD
#HappyCamperMD 

Steven M. Camp, MD
Fort Worth Plastic Surgeon
4.9 out of 5 stars 87 reviews

How long to wait before undergoing additional breast surgery?

I am sorry to hear about your concerns after breast surgery.  There are no absolute rules when it comes to how long to wait prior to undergoing additional surgery; in my practice, I would likely advise that you give yourself at least six months after the last procedure  before deciding whether or not to proceed with additional surgery.

Although I cannot provide you with specific advice, some general thoughts may be helpful to you. You may also find the attached link, dedicated to revisionary breast surgery (specifically breast implant rippling/palpability) concerns, helpful to you as you learn more.

Palpability and rippling of breast implants may be related to several factors. These include the amount of soft tissue and breast tissue coverage over the breast implants, the position of the breast implants (submuscular versus sub glandular), the type of implants (saline versus silicone), and the degree of overfilling of saline filled implants.  
Correction of the rippling may involve further surgery including implant pocket exchange if possible (sub glandular to submuscular), implant exchange if possible (saline to silicone), and/or the use of allograft to provide an additional layer of tissue between the implant and the patient's skin.   Specifically, given your photographs and concerns, I would likely recommend the use of  acellular dermal matrix if I were seeing you in my practice.
  I hope this, and the attached link, helps. Best wishes.

Time after implant exchange

Thank you for your question and for the photographs.

The minimum amount of time I advise my patients to exchange breast implants is 6 months. This amount of time help reduce the swelling and allows time for the tissue to relax. With Natrelle 410s, they take about 6 months to 1 year to settle, and require more patience than the round implants. 

Based on your photographs, you do not have enough fat for a fat graft.

Continue close follow-up with your surgeon. Best of luck!

Rippling of implants

 In thin patients such as yourself, rippling can be an issue with every implant that we have presently. If your implants are on top of the muscle then my recommendation would be to move them below the muscle. If they're already below the muscle and you still have this degree of rippling, I've had good success with Strattice as an onlay between the capsule and the tissue not only to thicken it but to make it less distensable such that the underlying wrinkles are now not visible through the skin. I agree with your surgeon that there is probably not enough fat to harvest to get the job done. Smooth wall, maximally filled gel breast implants such as the Natrelle Inspira or Sientra 206 one of the best likelihood in my opinion of both moving, and having less wrinkles. I would ask you, if you're my patient to wait at least three months before changing them out. Hope that's helpful. Good luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 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.