43 y/o mother of two, 4’11, 107 lbs, saline vs textured silicone?

At 4'11" and 107 pounds, I do not recommend going over 400 cc's and you would do much better long term with something smaller. I prefer the smooth implants, both saline and gel, for less long-term problems and excellent results.

Dear Metalmom30,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Hi Metal mom30,

Thank you for reaching out with your question about the choice between saline and textured silicone breast implants, especially given your specific situation as a 43-year-old mother. I appreciate the details you've provided about your background.

First and foremost, it's essential to note that textured breast implants are no longer recommended or widely used due to their association with a specific type of cancer risk. As a result, they are not manufactured anymore, and I strongly advise against using them. Consequently, the plastic surgery community, including myself, has shifted away from these implants.

When deciding between saline and silicone implants, it ultimately comes down to a combined decision between you and your plastic surgeon. However, most plastic surgeons, including myself, lean towards silicone implants for several reasons. Silicone implants tend to offer a more natural feel and appearance, and statistically, they are associated with a lower rate of capsular contracture compared to their saline counterparts.

Regarding the risk of sagging, it's important to understand that this risk is more closely related to the quality of your breast tissue and skin laxity rather than the type of implant used. Whether you choose silicone or saline implants, if there's a significant risk of sagging, it should be addressed during the surgery, potentially with a mastopexy (breast lift) procedure.

In summary, while textured breast implants are not a viable option, choosing between saline and silicone should be based on your preferences and the expert guidance of an experienced, board-certified plastic surgeon. They can guide you on the best approach to achieve your desired aesthetic outcome. I hope this provides clarity for your decision-making process, and I wish you the best in your journey.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon