Dear Dr. Reed,
Am considering 400 cc silicone. Your thoughts?
It is not unusual for the male chest to have more laterality of the nipple areola complex (NAC). For a female to have them off to the side doesn’t look quite right. The easy way to handle this is to choose a relatively wide implant, certainly not one that goes under your armpit. This will give more of the impression that you NAC is more centralized. Imagine if you wanted a smaller based one and of course want the implants together to show cleavage. This will certainly leave the NAC off to the side..
When considering implants remember silicones require a larger incision. Salines are inserted empty and an incision slightly wider than the base of your pinky will do. For MTF’s we favor placement unde the muscle, sub-pectoral to give more coverage than just your home-grown. Once under the muscle it is difficult to discern whether it is saline or silicone. Salines also have the advantage of being adjusted to the nearest volumetric amount to look balanced. Silcones are made in sizes 25 to 50 cc apart.
Still having said this, we find many of our patients are very insistent on silicone. Beauty is in the eye and the hand of the beholder.
Harold M. Reed, M.D.