Do silicone/gummy bear implants make the breasts generally feel hard to the touch the majority of the time? (Photos)

Question

I’m a 20 soon to be 21 year old Black female. I’ve been researching forever, I already have D size breasts however I rlly want them to be fuller ( not bigger ) & lifted for aesthetic reasons. I’m almost sure I’ll need a lift as well, but I know I want silicone or gummy bear, under the muscle , underarm incision if possible. Also do the nipples always lose sensation ? I attached the look I’m going for...

Daniel Barrett, MD · Answer

Hi Novaa9,
  
The two main types of implants are silicone and saline. The shell of the implants can be either textured (which reduces capsular contracture) or smooth. A textured implant sometimes requires a larger incision. The shape of the implant can be either round or tear drop shaped (gummy bear). Both have their advantages and disadvantages. 
  
The different types of implant offer different pros and cons. For instance, the pros of silicone implants are that they look and feel more natural and ripple less.
  
On the other hand, the pros of saline implants are that they do not require as large of an incision as silicone, less expensive, they have less incidence of capsular contracture (scarring around the implant), one can tell immediately if there is a rupture, the size can be slightly adjusted, and they can be used for women less than 22 years of age.
  
On the other hand, loss of nipple sensation is common after breast augmentation surgery. It depends on the operation but often times, sensation can return in a couple of weeks, a year, or not at all.  Nipple sensation itself is very important and can sometimes be lost with breast surgery. This is often mentioned in the risks of the consent process. 
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals. 
  
Daniel Barrett, MD, MHA, MS
  
Certified, American Board of Plastic Surgery
  
Member, American Society of Plastic Surgery 
  
Member, American Society of Aesthetic Plastic Surgery

William Aiello, MD · Answer

Hi Novaa9, Absolutely no implants should feel hard to touch. Breast implant patients that have hard, high breasts are usually experiencing a phenomenon known as capsular contracture. (This is when the scar tissue that naturally forms around the implants has thickened to a point it is squeezing the implant, moving it's original position and giving it the appearance of being really tight and hard.)Silicone implants do come in varying degrees of firmness. For example: Allergan Natrelle makes 3 different types of silicone gel implants, each one contains a bit thicker gel than the previous. They are all gummy, cohesive thick gel. Just think: Gummy, Gummier, Gummiest as your options. That being said. If you are already a "D" size breasts, you are going to feel mostly only your breast tissue with whichever implant you choose. I'm not really sure it makes a difference which thickness of gummy you choose. These implants sit behind the muscle and all of your breast tissue will be on top. You will see the added volume, but shouldn't be able to feel much, other than your existing breast.Which, brings me to my next point: Implants are going to add volume, which means your breast size will increase. If you are already a "D" and don't want to be any bigger, that's an issue. I'm a little confused you want them fuller, but not bigger. But I think I understand that perhaps you wish your breasts were positioned differently and the volume was distributed differently. For this you need to most definitely be looking at lift (mastopexy) with possibly a reduction if you want to add an implant for upper pole fullness. You need to meet with a surgeon who can examine you in person and show them your goal photos. You have to make sure your goals are in line with what your realistic outcome can be. My guess is that all the photos you have right now are of straight breast augmentation patients. And that none of them were starting out already at a "D" cup and got these outcomes. I would recommend you look at surgical before and after photos of patients who look more like you to start (before surgery) and see their outcomes after a mastopexy or reduction with/without an augmentation. These outcomes do not resemble those of straight breast augmentation patients that started with little to no breast tissue of their own. Finally, keep in mind the FDA has an arbitrary recommendation that patients must be at least 22 years old to receive silicone implants. You may find a surgeon who will allow you to get them anyway, with signing a warranty waiver. This may not matter, as after you meet with some surgeons, you may find your goals are met with a lift only and no implant at all. That's why it's so important to be seen in person and develop a relationship with a skilled doc. Every patient and case is unique. Good luck!

Tal T. Roudner, MD, FACS · Answer

Silicone implants should not make your breast harder as they are softer then saline implants. There are different types of silicone implants some are softer some are harder. But overall they should feel close to the softness of your own tissue. The size placement and shape could have an effect as well.A proper consultation would help guide you to what you should expect after surgery.Good luck

Mark Hanikeri, MBBS, FRACS · Answer

Hi and thanks for the questionIf you are already a D-cup and "don't want to be larger but fuller and lifted", then you don't need implants.  You may benefit from a breast lift procedure.  You should see someone about your options after a face to face consultation.  You can read my blog on the subject at the link below.Best of LuckDr Mark Hanikeri MBBS, FRACS (Plastic surgery)Perth Specialist Plastic Surgeon

Robert H. Hunsaker, MD · Answer

As far as the implants go, no. Neither silicone nor saline typically feel hard unless a capsular contracture occurs. In addition, if you have "D" cup breasts now most of what you feel and see will be from your natural breasts.Lastly, With large natural breasts and only wanting modest implants there will be real limits to how much upper pole fullness you will be able to achieve/maintain. It sounds like you would need a fair amount of diameter and projection for this to be the case. Of course, with no photos of how you look now, it is IMPOSSIBLE to have any opinion that applies specifically to you.

Jon Ver Halen, MD, FACS (license suspended) · Answer

Hello and thank you for your excellent question. It is best to answer your questions during a face-to-face evaluation, when you can discuss your goals and expectations for the procedure, and you can have a physical examination to evaluate for that procedure. Typically, gummy bear implants are soft. You should not lose nipple sensation after this procedure. I recommend that you find a board-certified, or board-eligible plastic surgeon with whom you are comfortable. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!
Best,
  
Jon Ver Halen, MD FACS
  
Harvard educated plastic surgeon
  
Texas “Top Doc” 2017, 2018
  
RealSelf100
  
America’s Top Plastic Surgeons, Consumer’s Research Council, 2010 - 2018

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