42 year old, mother of 2 sons. Op scheduled in 2 weeks. Considering 300 or 325cc silicone over the muscle. Advice? (photos)
Doctor Answers 14
Selecting the best implant size
The difference in appearance between the two implants would be very subtle. When patients are wavering between two sizes that are very close, I generally recommend using the larger implant. It is more common to have patients post operatively wish they had selected a larger implant than vice versa. In the absence of overriding factors I favor submuscular placement in all patients.
42 year old, mother of 2 sons. Op scheduled in 2 weeks. Considering 300 or 325cc silicone over the muscle. Advice?
I would suggest going with the larger implant, you also should discuss the possibility of placement under the muscle.
Good luck on your upcoming surgery! I still recommend under the muscle placement and the difference between 300 and 325 really won't make a difference either way. Best of luck!
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The difference between the sizes is minimal but I would recommend the larger of the two. Your goal photos would be consistent with this or even 350 cc. In terms of placement, you would achieve a better and more natural result under the muscle but the initial recovery would be more painful, which you indicate would be a negative. Good luck!
Implant size and position
should be chosen by you after having adequate time for sizing and finding the size that gives you the look you want. As for over or under the muscle, there are so many advantages to going under but healing as fast as possible is not one of them so you would have to decide if the trade-off is worth it for you. I recommend using textured anatomic implants above the muscle if my patient demands that we go above the muscle... otherwise the vast majority of my patients go under the muscle.
Considering 300 or 325cc silicone over the muscle. Advice?
Your photos show that you are a good candidate for breast augmentation. The difference between 300cc and 325cc is rather negligible at about 2 tablespoons. When in doubt, and assuming you tried on sizers, choose the larger implant because it will look a little smaller when in you than when you tried on the sizer. I am not sure why you (or your surgeon?) are choosing an over the muscle position..there is a greater risk of capsular contracture, and in a slender person you will see a more prominent upper edge of the implant and have a higher risk of seeing visible implant rippling.
Most would agree that placing implants under the muscle will lead to the least possibility of complications. As for size, that really depends on your biodimensional measurements, something that can't be determined with selfies. As for you wish pics, I can assure you that you WON'T look like them, especially the one you think your husband would love. This is because those women's breasts didn't look like yours before their surgery. You need to go back into your surgeons office and find some before photos that look like you do now: full but with some sag and a low position of your nipple. Finally, although your not asking, I need to remind you that the incision that puts you at the lowest risk for capsular contracture, the most common complication, is an inframammary incision. So please insist on it. Best of luck!
Over or Under and How Large?
It sound like you are really excited about your upcoming breast augmentation. As part of the preoperative visit your surgeon should measure your breasts and chest wall in order to decide what size and style implants will help you achieve the 'look' that you want. Make that visit count by communicating clearly, since time spent planning will help make sure that the results can match your expectations. Based upon your pictures I would probably suggest placing the implants behind the muscle, and I would probably suggest round smooth silicone implants since they are most likely to look and feel most natural. Regarding the size, precise measurements of your breast width and chest width are needed, but the volumes that you listed would be in the right ballpark.
Considering 300 or 325cc silicone over the muscle. Advice?
Thanks for your photos, your question and your shared enthusiasm! You appear to be a very good candidate for conservator breast augmentation however it is impossible to give you an exact answer to the volume question without seeing you in a face-to-face setting. I do think that the implants your are considering are adequate to slightly on the low side and in my office I would have a range of implants from approximately 300 mL up to even 375 mL available during the surgical procedure when the choice is best made. Based on the patient's goals and anatomy we place sizers or test implants to determine the actual contour and size during the procedure before selecting the final implant. My recommendation is almost always toward partial subpectoral placement of round mid profile or mid-plus profile smooth silicone implants although a few others prefer sub glandular. Discuss this carefully with your plastic surgeon and certainly enjoy your results.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California
Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery
I appreciate your question.
The size of implant best for you is dictated by your chest wall measurements. Once we determine that we can choose the profile based on what you want or need to achieve. If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance. Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.
Silicone will give you a fullness at the top (upper pole fullness).
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.
Anatomic gummy bear implants might be a good choice to give you volume.
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.
The best way to assess and give true advice would be an in-person exam.
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
Best of luck!
Board Certified Plastic Surgeon