Should I do saline or silicone? Especially what size should I get too? (photo)

Question

I'm 31 a stay at home mother of 5 kids that I breastfed. I'm 5'10 and 160 lbs my stomach is flat and so are my boobs! I'm done having kids so I thought I should work on me. Very scared have so many questions For my doctor. I'm scheduled to see Dr. Soler Baillo in a Miami, Florida. I was referred by a friend. I just wearing bathing because I have to buy a large because I have hips and a butt so the top is always to big for my breast. I just want to go the safer route and inexpensive too.

Gary M. Horndeski, MD · Answer

Your
photographs are inadequate but since you have breast fed 5 children and it is
highly likely that your breasts are ptotic. 
Many women focus on augmentation when they need a simultaneous lift to
correct the shape asymmetries and ptosis. 
If that is your case, 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. Best Wishes,Gary Horndeski, M.D.

Jose Perez-Gurri, MD, FACS · Answer

Its difficult from the pictures you submitted. Without actually looking at your breasts, it's all a guessing game. Because of the large weight loss and your breasts biegn post-partum, I would suggest using silicone gel implants. THis will definitely improve your chnaces of avoiding rippling and the feel to your breasts will be more natural. You don't have adequate tissue coverage and therefore the saline implants will be very palpable underneath.Without pictures, it's very difficult to recommend sizes of implants. They should, however, be placed behind the pectoral muscle. Always seek out surgeons certified by the American Board of Plastic Surgery who specialize in cosmetic breast surgery. Look at many, many photos to make sure that there is consistency to the work. Good luck.

Marwan R. Khalifeh, MD · Answer

Although the choice is a personal one, I would
be a happy to provide some facts about the two different options.

Silicone implants look and feel more natural,
have a lower risk of visible "ripples or wrinkles" and are currently
the more popular choice for patinets.  Physicians may recommend silicone
over saline for patients who are very thin or have little breast tissue to help
lessen the visible "ripples or wrinkles".  Silicone implants may
be recommended for patients using an over the muscle placement technique.

Saline implants are slightly firmer if
overfilled and hold their "round" shape better often making them a
choice for patients seeking a "fake" look.  The saline implants
are filled with fluid that is very safe if "leaked" into the body and
a patient usually immediately knows if they have a rupture or malfunctioning
implant, whereas a silicone implant rupture may be undetectable or require
expensive tests such as a MRI or Mammogram.

Both implants are FDA approved, come in several
different shapes, types and sizes and have been used for years safely on many
patients.

Rigo J. Mendoza, MD · Answer

Thank you for your question.  As far as size goes, you would need to have an in person consultation.  Given that you are thin, I would recommend silicone implants.  Saline will feel harder and more chance of seeing rippling on someone as thin as you.

John Michael Thomassen, MD · Answer

It is difficult to say without better photos.  Saline implants are less expensive but may be more palpable and give you a less natural feel if you are thin.  Silicone gels generally feel better and are indicated for thin women, plus the can be shaped like a teardrop and give thin women a more natural look.  The need for a lift also has to be considered depending on whether your breasts have dropped after breastfeeding.  Best wishes, Dr. T.

David Bogue, MD · Answer

The bottom line is that you need to consult with a board certified plastic surgeon who can examine you and give a recommendation. There is no way on a forum such as this to provide this service. As for going the "inexpensive" route - remember that a breast augmentation is REAL surgery. Often cheap comes from inexperienced or non-plastic surgeons. Avoid cosmetic "factories" and look at a surgeons qualifications. Be wary of board certified "cosmetic" surgeons as this is an obvious sign they ARE NOT board certified plastic surgeons. Also, see more than one doctor. Not everyone approaches these procedures the same way and finding the right "fit" is important. Best of luck!

Robert Brueck, MD · Answer

To my way of thinking there is no question to do silicone.I have doen so many over 30 plus years there is no questionb silicone is the best.i tell my patients the less tissue you have the more important it is to do silicone.As far as size goes I don't promise anything accept to make you as big as I can but look NATURAL.I make the pocket and will have 4 or 5 sizes available and whatever can fit into the pocket and look natural is what I give you.you can not put a gallon of milk into a quart conatiner.Good luck.

Jaime Campos Leon, MD · Answer

Thank you for the pictures.I can't really see your breast because they're covered, can you post other pictures? this way I would be able to give a review.Dr. Campos

Mel T. Ortega, MD · Answer

With out having a better photos of your breast to evaluated you, I could see you have no breast tissue and in order to avoid any rippling in the breast after surgery I recommend you to have silicone/(gel or gummy bear).

Steven Schuster, MD, FACS · Answer

Dear SexyMama5, Congratulations on your decision to have surgery and for doing your research.  As far as the saline versus silicone, the preference is yours.  I can give you my experience that silicone feels more natural and wrinkles less while the saline implants cost less.  There are more choices available with silicone such as shaped implants and various projections which may be of benefit to you.  As far as size goes that is something that requires a visit to a board certified plastic surgeon.  Many of them, myself included, have 3-D cameras that can show you how you would look with implants.  Size depends on your tissue characteristics, how much drooping you have, your chest dimensions and how large you want to be in the end.  You may want to go on several consultations before making your final decision.  Good luck, Dr. Schuster in Boca Raton.

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