I’m not sure what size implant I should get and if I should get Saline or Silicone implants - advice?

An examination in person would be required with proper measurements to determine exactly which implant would be suitable for you. That said, your breasts are pretty and normal. You appear to have a slight asymmetry (which, by the way, is also "normal" and very common), however you also appear to be a good candidate for a breast augmentation. You are off to a good start by providing photos of your "wish" result, however from a clinical perspective, standard medical views from a plastic surgery gallery would d be most useful to your plastic surgeon.

Volume (300 versus 400), is far less significant than implant width and projection. Implant width is similar to shoe size. The implant literally needs to fit into your breast and chest. The volume and projection are what will determine the “look” you want, similar to the style or type of shoe you would select. For a given volume a high profile implant will have a narrower diameter, and a person such as you with a petite frame will require a narrower diameter implant than a patient with a broader chest or larger frame. Other considerations such as saline versus silicone are also important, as are "round" versus "anatomical" or "form stable" or "shaped", smooth surface versus textured, and softer versus firmer with the different levels of gel cohesivity.

The term “natural” can mean different things to different people and the profile of the implant does not necessarily determine that. You can certainly achieve a “natural” appearing result with a high profile implant if properly selected, but as a rule, the larger the implant and the higher the profile, and certainly if the implant is positioned too high, the greater the chances you will look “augmented” because of exaggerated upper pole fullness or convexity.

In my practice, besides a thorough interview process and physical examination with careful measurements, we use on lay sizers within an unpadded bra to help you understand what you are likely to look like in a bra, bathing suit, or T-shirt with a given size implant. In addition, and this is critical, we ask all of our patients to provide us with photos of their desired final look, with images of women’s breasts that most closely resemble the look they are trying to achieve. This serves as a visual guide that thankfully rarely leads us astray. The most common reason for patient disappointment after breast augmentation is size-too big or not big enough. This algorithm which we have been employing for over thirty years has proven to be very successful.

Because all of these factors can leave you quite confused, it is crucial that you select an experienced board certified plastic surgeon whose aesthetics align with your own, and with whom you feel comfortable. Don't be reluctant to seek a second or even third opinion if necessary to be sure and feel confident about moving forward with scheduling surgery. Expressing your desired cup size is notoriously inaccurate, and final breast size is the most common reason for patient disappointment after breast augmentation, either too big or not big enough.

Take your time, do your research. Best of luck to you.

Thanks for your question! I would suggest a silicone implant in a submuscular position. I think a full profile would be best suited for your petite frame to get you a look similar to what you are hoping for. Seek out an in person consultation with a board-certified plastic surgeon. Good luck!

Hello,
Thank you for the question and the photos.
Implant size discussion and implant selection is one of the most important steps during your consultation with plastic surgeon. The decision-making process depends on patient’s desires, as well as breast and soft tissue dimensions of your chest wall. I also utilize Vectra 3D planning to further help with implant selection.
Based on your photos, 275cc-350cc range size implant will likely give you a nice full cleavage that you desire.
Typically, silicone breast implants are used because they offer more natural feel than saline (salt water filled) implants.
I suggest that you seek an in person consultation with a Board-Certified Plastic Surgeon in order to discuss your goals and concerns for the best cosmetic results. 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.
I hope this helps.Best regards, Dr. Karanetz
Dr. Irena KaranetzBreast Fellowship-TrainedBoard Certified Plastic Surgeon

Dr Swanson proved this in his open access article June 2020 in the journal Plastic and Reconstructive Surgery by scientifically comparing the two with ultrasound testing. After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Good evening,
It is really a matter of preference- saline tends to be a little more firm and perky, whereas silicone is the softest most natural look and feel you can achieve. From your description and photos I would tend to think saline might work better to achieve your goals!

Silicone implants feel more natural than saline. The technique I recommend is a mini lift. Using a circumareola incision, your breast tissue is reshaped, elevated higher on the chest wall and more medial to increase your cleavage. At the same time, fat transfers or small implants can be placed totally submuscular.

Best Wishes,

Gary Horndeski, M.D.

Hello!
Implant size is guided by your chest measurements and the fullness you hope to achieve. You will need to see a plastic surgeon in consultation to be sized. I place implants in a bra you will wear to get the best idea of what specific implants will look like. By the end of the visit you should be comfortable with the plan and understand which implant you will get.
Saline and silicone have very different characteristics - both are safe and FDA approved. Silicone feel more breast-like and should last you decades. Saline benefit is lower cost and adjustable volumes for asymmetrical breasts. Your plastic surgeon will show you the 2 different types of implant so you understand this as well.
Best of luck to you! Be sure to see a board certified plastic surgeon. You can find one at plasticsurgery.org.

Dear roze919,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Thank you for sharing your question and photographs. Breast implant selection is an exciting, but stressful part of the breast augmentation process as there are so many choices. Unfortunately it is impossible to recommend the best implant style, size or shape without an in-person examination that allows for the measurement of key breast parameters, as well as permits an in-depth discussion as to your desired goals and outcome. I would recommend seeing additional board certified plastic surgeons to ensure that the implants you decide upon are the right ones to meet your expectations. You may wish to "try on" several of the implants so that you can have a better visual representation as to what they would look like. For most patients a silicone implant placed beneath your chest muscle will be the best option. Best wishes!

The positives for saline are lower-cost. The negatives are increased firmness, more prominent rippling, and most significant is their tendency to completely deflate after rupture, demanding additional surgery.
The positives for silicone are their more natural softness and appearance, leakage does not result in a deflation therefore it does not demand secondary surgery. The negative is the additional cost of the silicone implant.
In my practice. I use approximately 98% silicone gel prostheses