I am such a waffler! Why is this so hard? I already decided that I am not swapping the implant I have for something else! Yet here I am, still thinking about it. I remember this .. this is how the whole “should I keep my nipples” thing went. Remember how that turned out? I think I made the wrong decision then. I want to make the right one now.

At my pre-op appointment last week I signed consent forms*, gave blood, got prescriptions for Norco and Cipro, and played around with some implants. Here are two silicone implants that are both 400ccs. The left implant is high profile, the right one is ultra high profile. The ultra high profile version is narrower at the base, and has more projection.

So last time: do I keep my Mentor round, smooth, high profile, 450cc silicone implant and match it on the other side or do I go for an ultra high profile version? As I said in my last post, I am not disappointed with what I have, but we could improve on projection. Here are some more answers that helped me come to the FINAL final decision:

• Will replacing the existing implant increase risk of capsular contracture? Even if we choose to keep the current implant, it will be removed to resolve the issue causing bottoming out. Either way, it is coming out and then something is going back in. Risk unchanged. (I didn’t realize this. I thought we’d fix it without taking the implant out.)
• Current implant has zero rippling (woo hoo!). Will a higher profile create that issue? It is impossible to predict this. Many factors come into play. Unknown.
• Will any pocket revision be needed? Goal would be to choose a UHP implant size with the base width close to current implant, so that no pocket tightening is needed.
• So how much difference in projection can we achieve with a swap? Depends on what size implant we choose. We went to the Mentor product guide to check dimensions.

This is what I have in now:

The UHP implant with the closest base width is 590ccs! That is just not going to happen. I don’t want the “done” look. My tissue expander is at 550ccs and it is already too much for my taste. I wouldn’t mind a little more projection, but that will come with overall increase in volume = bigger foobs. I am not comfortable with that idea. The options are:

We could do a 480cc or 535cc UHP implant, but the increase in projection is minimal (1cm at most, which is about the length of a finger nail) and I like my size now. So while yes, we’re going in there and the implant is coming out anyway, I love the fact that I have no ripples and that I know what I will look like on the other side. Let’s do only what we really have to and hope for the best! Fingers crossed surgery #5 will be a huge success and I will be DONE!

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*Carefully read your consent forms before you sign them. You do have the option to strike out or refuse some of the things you may not agree with. I do not consent to medical students/residents, fellows, or visiting surgeons performing any part of my procedures. I understand the need for teaching opportunities, but my plastic surgeon is the only one I want touching me (with the exception of his regular surgical assistants and OR staff).