Millions of breast implants have been placed over the last few decades making it the most commonly performed procedure by plastic surgeons. The advancement and technology has made these implants one of the safest medical devices on the market. Silicone gel implants are the most commonly used throughout the world. They simply look and feel the most natural and the risk of reoperation for complications such as capsular contracture, rippling and rupture is the lower than saline. I personally have not placed a saline implant in almost 10 years.   Implant choices are abundant. Smooth round implants are the most commonly used and come in various volumes as well as in various widths and projections. (think roundness) Anatomic/shaped implants are textured devices and have the most cohesion in their silicone gel. They too come in different projections to allow for either maximum outward push or minimal fullness.   So what about choosing a size? Everyone has a measurable base diameter to their breast. This is measured during the exam/consultation. The width helps give an idea of what will “fit” on the platform. Implants are like shoes, if you wear a size 6- you can’t wear a 4 or an 8 but you might cheat “1/2 sizes”.  Once the width is determined the amount of roundness desired is discussed. Some patients want a very athletic look while others want to maximize their volume and are willing to accept a very round but “unnatural” look. This is where having “wish” pictures is helpful to try and make sure that you and your surgeon are on the same page. The use of the 3D Vectra imaging system has made this process of implant choice much easier in that the system can generate simulations of expected postop images with different size/style implants used. Now the previous “Leap of Faith” is gone and patients know going into it what to expect.   Here’s what all goes into determining ideal implant and size:

  • Base diameter of breast
  • Quality of skin/ Amount of stretch of skin
  • Original shape and volume
  • Desired appearance

  Far and away the most common request is to be a “Full C”. Because of differences in the individual’s native breast this could mean 150CC or 350CC.  

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