I have a professional career and I work out 3 to 4 days a week. I have a athletic body and narrow hips. My concern is that I will be "top heavy." I currently have 500cc saline implants and one is leaking that is the reason for the revision. What would you recommend?
I'm 5'9 130lbs Going for Revision. Surgeon Recommended 700cc High Profile Silicone. Im Concerned That It Too Big?
Doctor Answers 9
Goals for breast revision
The goal of breast surgery is to create beautiful breasts. Beauty depends on multiple factors: position of the breast on the chest wall, roundness of the breast, symmetry, areola position, skin tone and least of all volume. If you are satisfied with the current size, you can replace the leaking implant. If you want larger breasts, you would have to increase the implant size. Howver, larger implants such as 700 cc have more complications and droop sooner. You may be better off with smaller implants and a breast lift. There is a new procedure called The Mini Ultimate Breast Lift which elevates the breast, improves the shape and adds upper pole fullness without vertical scarring.
Gary Horndeski, M.D.
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What size implants should you choose...
As mentioned, you need to make this decision for yourself. You can size with external sizers to get a good idea of what different sizes will look on your body. To facilitate this, your doctor could intentionally deflate your good implant so you can get an accurate sizing and still get your warranty coverage on your leaking side. Everyone has different ideas of what is good. Let your doctor know your goals and I would never let someone else choose a size for me as I've seen to many mistakes from this.
If you're fit and thin, you may want to consider switching to gel implants. In addition, you will never be faced with a deflation again.
"Revising" breast augmentation
The main issue here is what a revision is and what are your goals. The surgery needs to fit the goals.
If you have a "leaking" or failed saline implant then the procedure needed is a replacement of the failed implant rather than a revision. The simplest way to do this is to replace the failed implant with the same size and type of implant and only deal with that side. In the first 10 years this would be covered by the Mentor or Allergan replacement guarantee and you would have no or little out of pocket expense as well as recovery.
If you want to be bigger or change from saline-filled to silicone gel-filled implants then that is not a revision but rather a choice on your part which you can make whether or not one implant needs to be replaced. If everything was properly done and settled with your existing saline implants, then the only reason to change to gels is for the feel where the implant is currently felt. If you change the size you can generally increase the width of the implant by about 1 1/2 cm (which also increases the height in a round implant) and you can increase the forward projection if you're not already at a high profile. Choosing an arbitrary number of cc's to increase is similar to choosing an arbitrary number of cc's for the initial augmentation implant. Implants are properly fitted by dimensions, what the tissues are known to tolerate, and what effect is desired, not starting from the number of cc's and working backwards.
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Very large implants not recommended
In my opinion, as a woman, if you have a professional career and have an athletic body with your workout schedule, I would not recommend 700cc implants. I would replace the implants with the size you currently have or even smaller, depending on your skin quality and amount of ptosis.
Large Breast Implants Do Not Come Without Their Share Of Potential Complications
My first comment would be that if you think 700cc is too big, then it probably is. Your comments bring several questions to mind. And, if you are active and athletic this increase in implant volume may be very undesirable.
Do you want to be larger, or is that your surgeon’s recommendation/choice? For many women, I would consider the 500cc implant you have now to be a “large” implant; since you are a bit taller, it may be less so for you. A switch to 700cc is a 40% increase in size from what you have now, and will likely increase your breast size by one cup size.
Do you have high profile implants now? Or is your surgeon recommending a larger volume high profile implant as a change from a more moderate profile you have now? If you don’t have a high profile implant now, do you want the increased projection that a high profile will provide?
What is the current size (rated volume) of your saline implant now? Is it overfilled? If so, how much?
And, what is the diameter of the current implant you have? How does the diameter of the proposed 700cc high profile implant compare to what you have now?
Do you want silicone, or is that your surgeon’s recommendation? And are you okay with that? You need to be comfortable with the type of implant you have, since you have to live with them.
Size is of course a personal desire/choice, but you also have to consider the potential morbidity of large implants – increased implant weight, aggravated skin stretching, skin thinning, breast gland atrophy, the subsequent possibility of (visible) implant rippling, delayed breast drooping, etc.
A few pictures would be helpful to make more directed comments. And of course, an examination is also necessary for this decision making process.
Take a Ziploc bag and add almost 7 ounces of uncooked rice to it. Place this in your bra. It should give you an estimate of the volume increase. What it will not accurately show is the change in implant diameter and projection depending upon if you are switching from a moderate profile implant or not.
If your surgeon has not discussed all of this, you may want to inquire so you fully understand the consequences of this revision surgery.
Best wishes, Ken Dembny
700cc implants are big
Certainly a 700cc implant is big when you consider the average implant size is closer to 350cc. You are wearing a 500cc implant, and if you wish to go larger then at least 150cc to 200cc will be needed to make a visible difference. Though 700 is big, it might be right for you. Show your surgeon just how you wish to look after the revision, as big is a personal decision.
Implants that are too big
It all depends on what you mean by "too big." Obviously you are having an augmentation to produce a certain look. If you have an augmentation that is extremely "safe" but does not produce your desired look, you will be disappointed. On the other hand, a certain goal might require an implant that is so far afield from what your body can handle LONG TERM that it will not be "safe." You need to have a frank conversation with your surgeon about safety and what a reasonable size would be for your body.
I often start with the implant that will produce the most natural look (i.e. lowest profile) and that fits the dimension of your natural breast. If that does not produce the desire look and the profile and dimension needs to be increased, eventually you will have an implant that produce unnatural AND unsafe long term consequences. I suspect that a high profile, 700 cc implant is in that extreme range for a patient your size.
Robin T.W.Yuan, M.D.
Is a 700cc Implant to large?
Difficult to answer without pictures and an exam. Implant size has lots to do with personal preference and what body shape/chest shape you have. In addition there is usually a difference in post-op size and shape between silicone and saline even with the same cc's. I would recommend another consult if you are not happy with the pre-operative plan, revisionary breast surgery is always difficult and getting a couple of different opinions always is worth it.
Surgeon Recommended 700cc High Profile Silicone. Im Concerned That It Too Big?
500 cc are rather large already, 700 cc still larger. A photo would help.
What you haven't said is whether you want to be larger, or if it's your surgeon! If you are happy with the current size, I would stay there. 700 cc would probably make you a cup size larger. This should be your call, not your surgeon's. The surgeon can help you decide what you want.
Thanks and best wishes.
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