You're right that switching to the 5th generation gel implants will give you more upper pole fullness than your current saline implants. Secondly, you'll need about 150 CCs to see a noticeable change in size. I rarely if ever hear from patients that they wish they had gone smaller, so I always favor going to one size up--470. Good luck.

Published on Jul 11, 2012

The difference between higher and lower profiles for a given volume is projection and for a given width is volume (with the high profile implant being greater in both scenarios).

The moderate plus is the most commonly used profile in my practice. It allows for the most reasonable volume in a given BWD. In my practice, low profile implants are the least commonly used (widest and flattest). I will typically reserve high profile devices for smaller framed individuals or those seeking a less subtle, more dramatic change (the opposite of natural).

In general, the difference between a high and Mod (+), in reality, is very small (on the order of millimeters). In my practice, I generally classify profile based upon patient preference. A higher profile provides a more dramatic look (size for size) vs. a moderate (+) profile, which is relatively more subtle and understated.

That being said, the vast majority of patients will select a moderate + profile device (especially those seeking a more natural and subtle result).

Finally, it is important to remember the implant will not create cleavage. Cleavage is a function of anatomy and wider set breasts will be wider set and larger post-augmentation. If your goal is greater projection, the HP is recommended for it provides greater volume and projection for a given base width.

As always, discuss your concerns with a board-certified plastic surgeon (ABPS).

Published on Jul 11, 2012

This can be very hard to select when there are existing implants in place. We use Crisalix software which, while not perfect, does allow us to "subtract" the volume of a prior implant and "add back" a new implant selected from the catalogue of available implants in order to project a possible outcome for the patient. This is VERY helpful when trying to pick among different devices.

HP devices basically are my top choice because unless there is a compelling issue like tuberous shape or super thin tissues, the added forward projection is usually more desirable than distributing the volume horizontally along the base diameter.

Published on Jul 11, 2012

If you're implants are too far apart, the pocket may be disproportionately large and the implants may fall off to the side when lying down. A capsulorrhaphy will make the pocket smaller which will necessitate insertion of a smaller implant. However a fuller and more projecting breast can only be achieved with a larger implant.

Michael Eisemann M.D.
Houston
Texas

Published on Jul 11, 2012

Thank you for your question! The moderate plus will give you projection but in a little more a natural, "tear-drop" look, typically with the width of your own natural breasts. The high profile series is designed to have more projection than a moderate series, but with a more narrow base width dimension. You will receive more upper pole volume with the moderate profile, but the difference between 470cc and 455cc is minimal.

Published on Jul 11, 2012

It is very difficult without seeing you in person to know if the implant sizes you mentioned will be appropriate for you. Keep in mind that the size difference between the 455cc and 470cc is minimal. Some studies have shown that it is nearly impossible to see a difference that is less than 20cc. Also, implant size selection depends on your unique measurements, so the largest size will be limited by your measurements and anatomy. We have a device called the Vectra 3D imaging system that shows you what you will look like with any implant. Our patients are very happy with the choice of implant they make when using this system.

Published on Jul 11, 2012

I would go with the HP device or even the UHP device if you really want more projection. The moderate plus does a great job at making patients look natural, but it doesn't provide a lot of upper pole fullness. I hope this helps.

Published on Jul 11, 2012

Thank you for your question.
Unfortunately, online consultants cannot give you accurate advice.
Ultimately, careful selection of your plastic surgeon and 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 revision 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 words such as “small C cup” or "bigger” 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 helps.

Published on Jul 11, 2012