Saline breast implants v Silicone breast implants
It is important to understand that breast implants will increase the volume of your breasts as the primary goal, so the diference in how your breast look, will not be significant just based on the use of silicone versus saline.
In a general fashion, regular silicone implants (cohesive) feel more natural (softer) and anatomical implants (gummy bear, highly cohesive) will look more natural.
Saline implants are easier to detect a rupture. The shape of your breast will depend in the size of your natural breasts and the quality of the skin, less on the type of implants based on the limited information obtained from your pictures you have a significant diference in size and shape of your breasts and you most likely, will need a lift procedure.
Be sure you seek the help of a Board Certified surgeon preferably a member of the ASAPS.
650 cc implants are quite large and you may not be able to handle such a large implant at first.
If the tissues are tight it might not be a good idea. Best to be evaluated in person.
D cup
To go up a D cup you do not require too much volume. I would recommend a Moderate Profile implant in the 275-350 range. This should fit your breast width nicely and not appear excessively augmented.
Breast augmentation
You are an excellent candidate for a breast augmentation. It does not appear like you have any breast droop or excess skin so no lift will be necessary at this time.
I also prefer silicone implants, placed partially under the muscle, in what is called a dual-plane position. We can get you to a full C or D bra size with a natural appearance. I usually ask patients to either bring in a photo or pick a photo from our book on breasts they like – this way I can assess many factors such as size, cleavage, perkiness, and projection.
Breast implants actually lower the risk for breast cancer.
There are studies that statistically show that women with breast implants actually have a lower risk for cancer than those that don’t. It is a modest difference but it is indeed there. This observation is certainly no reason to submit to an augmentation you would otherwise not have, but it is nice to know that we are not pushing the cancer risk in the other direction.
Periareola and submuscular
The straight forward answer is yes yoour implants can be placed periareola and submuscular. I must have done thousands that way with great success in my years of practice.
Natural looking implants on a lean body.
You are correct in all your assumptions. I always tell my patients that the larger the implant and the smaller the breast the more “unnatural” the results will be. Its a matter of relativity. What we can do as plastic surgeons to minimize the appearance of the breast implants is to place as much soft tissue as possible over the implant (i.e. under the muscle) . We also would use an implant that is appropriate in size with the amount of soft tissue coverage available. I would be sure to convey your thoughts to your board certified plastic surgeon and ask to see results of his/her work so that you can get an idea of their artistic skill.
Key to a good result is a good plastic surgeon
If you choose a good plastic surgeon you will have good results. That is the key. Size, type and location of implants is dtermined at time of consultation. You can achieve your desired look.
600cc?
When choosing an implant, there are many different factors that come into play. Your goals have to be balanced out with your available soft tissue coverage and measurements. Whether 600cc is right for you or not can only be determined by a direct examination.
However, using an UHP device will give you the rounded fuller looking breasts as seen in your ideal pictures.
Incision placement for breast implants
Implants can be placed through several different incisions. Sometimes if the areola are small, they may not accomodate a silicone gel implant which is always pre-filled. Saline implants have the luxurtry to go through a smaller incision because they can be rolled up.
you look like a good candidate for breast augmentation. However, a in-person consultation / examination would be required. If you are happy with the doctor and the results that you see in other patients, then go for it.
Don’t try to make the surgeon do the surgery a different way than what they usually do. If you do not want the sub-facial procedure then seek out a board certified plastic surgeon that does submuscular implants.
In my opinion, submuscular is the best placement in the majority of patients, but there are differing opinions.
Repositioning implants after multiple pregnancies
What you describe as only one inch of skin below your areola is strange. Ptosis of the breasts (sagging) is usually associated with both the superior and inferior portion of the skin stretching. One possible solution is to move your present implants from behind the pectoral muscle to on top of the muscle.
Implants behind the muscle tend to ride higher and cause the breast and nipple complex to appear lower that normal. A surgeon should be able to tell. If done correctly, mastopexy scars are not unsightly and are barely noticible after nine months.
Choosing large breast implants
Your surgeon is likely trying to provide you with advice that will keep your body form and breast size somewhat proportional. Remember that a small breast means a small skin envelope, a very large implant in this small envelope can look very badly.
I council women to try and choose an implant that is going to be proportionate to their body and commensurate with their wishes, but still provide a beautiful breast form and not look overstretched and overdone.
It is likely that the plastic surgeon that you saw is similarly trying to optimize your outcome.
Breast implants can feel very natural
The way an augmented breast feels after surgery can vary depending on which type of implant is used (silicone or saline), how much breast tissue is covering the implant and whether the implants are placed below or above the muscle.
Saline implants may feel slightly firmer than silicone, but neither type of implant will feel hard to the touch. In cases of capsular contracture, which develops in a small percentage of breast augmentations, the scar tissue around the implant may harden, but this can be resolved with implant revision surgery.
The best way to get beautiful results that look and feel natural is to be very particular about your choice of plastic surgeon.
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