Silicone or gummy? 100cc or 135cc higher?

The difference you speak of is only 2-tablespoons, so it isn't that significant.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Hello,Go on line to make sizers of various cc's and try them on. This will give you an idea of how much larger to go. Best of luck!

Dear theresafoster,I recommend you have this discussion in person with a plastic surgeon because everyone's breasts are different but generally speaking the shaped gummy bear implants will allow more upper pole breast fullness but can diminish the amount of cleavage. I typically don't recommend these unless you have very small breasts to begin with or have had a mastectomy. I see no advantage to a round form stable implant.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

it leaves a shell estimated at around 30 cc's.  You can resize over this with external sizers and unlined bras to get the most accurate sizing.  Whatever you choose in sizer volume is increased by 10% to compensate for whatever diminishment that occurs when placing implants.  And don't forget to add the 30 cc's from your deflated shell to get your final volume.  So if you like 300 cc sizers on top of your breasts, 10% is 30 and the shell is 30 so your implant used would be a 360 cc implant.  As for the base, that is dependent upon your current look and what your goals are.

Thanks for posting. Silicone gel comes in highly cohesive type which is firmer (gummy bear) or comes in less cohesive standard types. There are several factors that can help you decide which is right for you, such as the look and feel you are going for, the amount of breast tissue you already have, and the size you are planning. In general, changing implants from saline to silicone does not call for a change in volume. If you are changing base width or profile, then a volume change may be needed, particularly if you are unhappy with the look that your current saline implants have given you.You would need a detailed, in person visit with and American Board of Plastic Surgery certified plastic surgeon to help you make these decisions.

Silicone gel breast implants come in many different forms these days and what is best is a very confusing topic for both patients and surgeons.  Most patients who are considering a breast augmentation, either for the first time or as a replacement for other implants as in your case, want the following:

A breast implant that feels as natural as possible.
Minimal complications from their implant like:
Capsule contracture.
Rippling.
Rupture.
Under the muscle animation deformity.
While we do not have a perfect breast implant yet, the implants that are made by Sientra are as close as we have so far.  They are gummy bear and thus have almost no chance of rupture and have minimal rippling (either above or below the muscle).  They have been shown to be very natural feeling.  They have the lowest capsule contracture rate of all the available breast implants and because they are available with a textured surface, they can be placed above the muscle even if that is where your old implants were placed (a capsulectomy is not required) in order to avoid an amination deformity.

Sizing with these implants is very easy.  We simply have you use trial implants in a bra over the deflated saline implants.  We do use your breast diameter measurement to help choose the just the right implant so that you do not have “side boob” but get the cleavage and projection you want.

I have added a video and web reference about these implants for you. 

I hope that helps. 

Best regards.