Which silicone implant will give me the best results? (Photo)

My doctor first suggested 325cc hp smooth silicone implants. I went back a second time because I was concerned that might not look and feel as natural as I wanted so then he suggested 300cc moderate plus. Which will give the best results? He also said I had a wide gap in between each breast and said something about from my neck to each nipple being 20,20,20. I'm not sure if that's helpful. Also I'm 5'3 115 lbs. I'm 23 so I want what will look the best for my body

Doctor Answers 13

Implant Selection

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Thank you for your question. It is much better to accurately discuss implant volume and projection with an in office exam and detailed measurements.

In order to make an accurate size recommendation, I would need to assess your chest wall and breast mound measurements/characteristics. I use these measurements to help me during the sizing process to guide you to a safe result for your chest wall and just as important, one that meets your end desires.

The next step is to try on this range of implants in the office with your doctor. The key to this success is showing your surgeon the body proportion you desire with a bra sizer and allowing your surgeon to guide you to the right implant. It will be much easier to communicate in implant cc's than cup size when determining the appropriate implant for you during the sizing process.

In addition, review of photos and use of rice bags can be very helpful to the patient and surgeon in achieving a safe and happy result. Close intereaction and involvement from your surgeon during this process can help alleviate the anxiety and fears of choosing the right size.

I wish you a safe recovery and fantastic result.

Dr. Gill

Houston Plastic Surgeon

Implants alone are inadequate

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Implants alone will not give you the results you desire. Your nipples are too far apart and 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. 22% of women who undergo breast augmentation alone require revision within 2 years because they are dissatisfied with the results. This will most likely happen in your case because your nipples will be too far apart and will have too much gap between your breasts.

Best Wishes,

Gary Horndeski, M.D.

You have significant asymmetry to start

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Your right breast is very lateral and will be more obviously different after augmentation.  I would examine you and evaluate other options including fat grafting with BRAVA

In breast augmentation I have chosen to spend time reviewing photographs with patients to fully understand their expectation of size and shape. Many times this simply raises more questions. I will make measurements and use the implant guides to allow the patient to understand exactly the sizes that are reasonable for their body type and measurements.

Please find an experienced Board Certified Plastic Surgeon and member of the Aesthetic Society using the Smart Beauty Guide. These Plastic Surgeons can guide you on all aspects of facial surgery, breast augmentation and body procedures including tummy tucks or mommy makeovers!

Moderate profile plus breast implants best for widely separated breasts

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Thank you for your question.  It is most important to follow the advice of a board certified plastic surgeon who has examined you and make recommendations.  On
Advice may be well and tensioned but does not have the benefit of examining you.  Having said that I concur with other surgeons that wider base to moderate profile plus breast implants would be my choice and someone who had widely separated breasts.

Which silicone implant will give me the best results?

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Thank you for the question and picture. Base on your photograph, you are starting at a great place and should have a very nice outcome with breast augmentation surgery.  However, despite good intentions, online consultants will not be able to provide you with  meaningful specific advice.  Ultimately, in person consultation with well experienced board-certified plastic surgeons will be necessary. Careful measurements, dimensional planning, and careful communication will be key.

Generally speaking, the best online advice I can give to ladies who are considering  breast augmentation surgery ( regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your   desired goals  with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "C or D cup" etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.  The use of computer imaging may be very helpful during this communication phase.

3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

I hope this, and the attached link, helps.

Which implant is best

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I would agree that based on your photo that you have a significant gap between your breasts.  An important measurement you did not mention is the base width of your breast.  This measurement helps to determine the appropriate profile.  I am guessing a bit without that measurement but based on my experience you are likely going to get better medial fullness with a moderate (Mentor moderate plus) profile implant.  Be sure to discuss this with your surgeon.  Ask him or her about the base width measurement.  


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Thank you for the picture.

I do agree with your surgeon, a 325 cc implant will give you the volume you're seeking.

Dr. Campos

Implant style and size

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The difference in volume between 300 cc and 325 cc implants is very small.  This is less than a shot glass, and honestly would be difficult for anyone to tell the difference easily - volume wise.

I always measure the breast width diameter when considering implant selection.  Based on this and your desired volume, a variety of implants will "fit".

Maximizing your diameter will decrease your projection.  As your nipple must be centralized over the implant (and breast mound), a wider diameter may give you more cleavage and ensure better centralization of the nipple areolar complex.  A wider implant will give less projection though.

All this depends on the width of the implant that will fit your breast.  

Talk to your board certified plastic surgeon.  They will help you decide.

Implant profile

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Much depends on your concept of natural. The HP implants have more projection, which is not always particularly natural appearing an a slender patient, but not unattractive to some. The moderate plus implants usually look more natural as I assess appearance, but not all would agree with me.

One missing measurement is breast width. One of several keys to a natural appearance is to use an implant with about the same diameter as the breast is wide. The smaller moderate plus is wider than the larger HP, and that could factor into your decision. 

I expect you will have a nice result with either choice. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Proper Implant Selection

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The only way to provide a truly acceptable answer to your question is to see you in consultation and perform an examination. Otherwise, only generalizations can be offered.

Breast base width is one of the most important measurements, but decisions regarding implant selection are also based upon breast size and shape, tissue compliance, and the desired appearance. In most circumstances it is very important to respect the dimensions of the breast (esp. with a subpectoral augmentation) and the skin envelope tissue compliance to achieve a natural result and reduce post-operative morbidity.

In general, the width of the breast implant should not exceed the base width of the breast by more than a few millimeters. A subglandular or subfascial augmentation may allow you to choose a slightly larger diameter implant, and may help you achieve more narrow cleavage. In a subpectoral augmentation, the medial extent of the pocket is defined by the origins of the pectoralis major muscle; these origins need to be respected and left intact. Therefore, trying to narrow cleavage is difficult with a subpectoral implant location, and the distance between the breasts remains unchanged. The risks and the benefits of these pocket locations need to be considered carefully when making decisions regarding the final result you desire, and can be discussed with your surgeon in detail.

Implant profile also plays a role in the final breast shape. I think moderate profile implants tend to produce a more natural result because they are less spherical in shape. High profile implants tend to produce a shape that is more round and has more projection, but not necessarily more upper pole fullness. In women with narrow chests moderate profile implants sizes are sometimes limited, and higher volume options are available if high profile implants are selected instead. If using implants in a subglandular position to narrow cleavage, then high profile implants should be avoided and moderate profile or anatomic implants are better options.

You should consult with a board-certified plastic surgeon who is experienced with breast augmentation. The consult should allow you the opportunity to describe your desires for breast size, shape, and implant type. A thorough exam should be performed. You should understand all the differences between saline and silicone gel breast implants. The risks and benefits of the proposed operation, as well as the estimated outcome should be discussed in detail. The first step to a good result is a trusting and open relationship with your surgeon. Different surgeons will have different recommendations, so more than one consultation may be beneficial for you.

Best wishes. Ken Dembny

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.