To avoid rippling, is it better to get 700cc saline overfilled to 800 under the muscle or 800cc silicone under muscle? (Photo)

Good afternoon!
I probably place more overfilled saline implants than anyone else in the U.S., more than 200 times a year, and the secret to reducing the rippling is a 20% overfill over the top number. So for instance, if you chose the Mentor Mod Plus 800-960cc shell, I would recommend we overfill it at least to 960cc = 20% = 1150cc. You can apply this formula to any shell size you choose! And the conventional wisdom says silicone ripples less than saline, but this really isn't true when you consider overfilled saline implants.

Dear oraphim,
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