Implant exchange to achieve more fullness up top. Deciding between saline and silicone and size for replacement. (Photo)

I am currently 32 years old, no children and had BA 8 years ago, 68HP saline nutrelle 280cc's filled to 300cc's. I did have existing breast tissue prior to surgery, small B (C in VS). I have not been able to wear strapless anything and have been dependent on push up bra's. I want to achieve more projection/roundness at the top of my breasts. I am trying to decide between saline moderate profile 450cc's or silicone. I am looking at an increase in size to increase the diameter. Advice?

Doctor Answers 5

Redo breasts augmentation

Dear Angie,
 Thanks for submitting your pictures. From observing your pictures, you appear to be C cup size with lateral implants displacement and ,at least, medial capsule contracture  (possible superior too ).
 You did not provide your chest circumference , which is critical for correct implants size selection. If you are presently 34 C cup size,  450 cc implants will bring you to 34 D cup size , which is very attractive. That size will also create more fullness  at the upper pole.
 To obtain a nice shape of breasts, you will benefit from lateral capsulorrhaphy (internal bra) and medial capsulotomy (release of capsule)  which will give you a very nice cleavage.
  In my 28 years of practice, with thousands of breasts augmentation patients, I have used almost exclusively saline implants for many reasons that are too numerous to spell out at this session. I will be glad to provide them to you if you contact my office.
  Always, consult with experienced board certified plastic surgeons , who operate in accredited surgery center for your safety. Check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent and attractive with nice shape and nice cleavage.
                   Best of luck,
                                       Dr Widder

Type of Breast Implant with Revision

With both implant types there are choices when it comes to size, shape, and profile. The criteria best to suit you will be discussed in full detail at your breast augmentation consultation. Each implant have their benefits. #SalineImplants is made with a #silicone outer shell that is filled with saline water during the surgery. It is filled with sterile saline (salt-water). Since saline is like normal body fluid, it is safe and easily absorbed if the implants were to leakThe #implant shell is ordered in a specified size which can be filled to a minimum or maximum fill amount. This allows the plastic surgeon some flexibility with sizing during surgery. Often times a woman has breasts which vary slightly in size. If one breast is slightly smaller than the other, each implant can be filled to a different amount to create better symmetry. Saline tends to be a little less natural feeling than silicone, but it can also create a more dramatic upper breast appearance, which some women prefer. A new saline breast implants option called Ideal Implant™ was recently FDA approved and was created for women who are not comfortable having silicone implants in their body, but desire a more natural feeling implant than traditional saline implants on the market. The unique structure of the Ideal Implant allows for a similar look and feel as silicone with the safety of saline. 

#SiliconeImplants are made with a silicone outer shell and are filled with a gummy-bear consistency silicone on the inside. More women tend to choose silicone breast implants due to the natural feel and appearance. Silicone implants are now made of a cohesive gel which are anti-leak even when cut. Look and feel like natural breasts due to the cohesive silicone gel material. New generation silicone gel implants are far superior than those used in the past and have a proven track record of safety. Silicone implants have gone through more testing than any other medical device and are the preferred choice for over the muscle implant placement. 
To further ensure the safety, the FDA recommends women have periodic MRI testing to ensure their silicone implants are free from any defects.
#Shaped implants are all #textured and should not rotate when used properly. In my practice, about 20% of the patients benefit from shaped implants. Your Plastic Surgeon needs to measure you and determine the best shape and size of any implants that are used.Any cosmetic #revision has risks of unhappy outcome or other complications. Also, the right implant for the revision is contingent on shape of body and your desired outcome.  

Your procedure should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for another revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient #reviews. Gathering all of this information will help you make a well-informed decision.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 96 reviews

Implant exchange to achieve more fullness up top. Deciding between saline and silicone and size for replacement.

Yes 450 cc Silicone mod profile+ AND Fat Grafts to upper poles.............................................................

Implant exchange to achieve more fullness up top. Deciding between saline and silicone and size for replacement.

Thank you for the question. Keep in mind as you are thinking about your goals that sometimes adjustment of the breast implant pockets (capsule adjustments) may be necessary to achieve the outcome you are looking for. Also keep in mind that there is no accurate/reliable/predictable correlation between size/profile breast implant utilized and cup size achieved. Furthermore, there is no accurate/reliable "conversion" factor when it comes to exchanging saline to silicone gel breast implants.

Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery 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. I have found that the use of words such as “natural” or "up a cup size” or "D or DD cup" or "more fullness at top" 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.
3. Once you feel you have communicated your goals clearly, allow your chosen plastic surgeon to work with you in determining the best plan to achieve your goals.

I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.

Leave them alone

I think you have an excellent result. Your breasts look very nice. Yes, with larger implants you may get  more upper pole fullness but eventually they will fall a bit and may cause sagging( they will be heavier, right?).  

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

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.