HP or Mod+ implants please? (photos)

Question

I want to get 550/600cc implants. But I'm not sure which base (HP or Mod+) will allow me to best achieve my ideal look. Could you please help me make my final decision? Thank you so much! :)

Jerome Edelstein, MD · Answer

Hello,Thank you for your question and the wish photos. You appear to want a large, full result with plenty of upper pole fullness and cleavage. Your specific measurements will determine the implant size/cc's which are a reasonable fit, however a full projection will likely be more in line with the look you like. My patients find it helpful to try on the implant sizers with a form fitting T-Shirt in the office in order to get an idea of their look.All the best

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.

The size of implant 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!

Dr. Schwartz

Franklin D. Richards, MD · Answer

This is a commonly asked question. The short answer is that you should pick an implant that will best fit  your chest width. Your plastic surgeon can measure the base of your breast and an appropriately chosen profiled implant can then be made. However, with the size of implants that you are considering you would need a wide chest to accommodate anything other than a high profile implant. A moderate plus implant could give you more side breast than you wold like.

Nana N. Mizuguchi, MD, FACS · Answer

In your situation, you need both volume and width.  Most of your wish pictures show very close cleavage and large breasts.  The width is absolutely necessary to fill the gas between your breasts.  I would think a HP but would consider using implants of the correct size and width of Natrelle Inspira or Sientra 107.Best Wishes,Nana Mizuguchi. MD

Tom J. Pousti, MD · Answer

Thank you for the question.  Based on your photographs, it is likely that you will benefit from breast lifting as well as breast augmentation surgery. Generally speaking, patients undergoing this combination operation should understand that it is significantly more complex than breast augmentation surgery only and that it is associated with a significantly higher risk of complications and need for additional surgery.  It will be important that you educate yourself regarding the pros/cons/risks/complications associated with breast augmentation/lifting surgery.

Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.

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 are 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 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. For example, I have found that the use of know words such as “natural” or "full C, small D cup” etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
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, after the use of temporary intraoperative sizers.I hope this (and the attached link, dedicated to breast augmentation/lifting surgery concerns) helps.  You will find a separate page, on the same website, dedicated to "larger" breast augmentation surgery concerns as well.  Best wishes for an outcome that you will be very pleased with.

Hiroshi Nishikawa, MD, FRCS - Account Suspended · Answer

It is very difficult to judge what kind of implant to place under the breasts from photographs alone. I am sure your surgeon will be able to give you the best advice after a thorough clinical examination of the amount of breast tissue available and the actual chest diameter measurements. Careful clinical assessment will allow the surgeon to predict whether a low or high profile implant should be used.  The final look of breasts after implant insertion is dependent on quite a number of factors, which not only includes the surface area of the anterior chest wall, but also the quality of skin and the amount of available breast tissue and degree of droopiness (ptosis). Finally, the choice will also be influenced by the cosmetic look the patient desires.  In general, for thinner women who have narrow chest walls and who want a lot of projection and fullness, high profile are more often used, but experience and good judgement is required for the final decision.

Richard P. Rand, MD, FACS (retired) · Answer

You will not get near your goal photos without high or maybe even ultra high profile implants IMO. A mod plus is too flat for what you want. Also please understand that you may need a lift also because of the lower position of your nipples and that isn't included in your goal pics.

HP or Mod+ implants please? (photos)

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