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Does Breast Implant Replacement Necessarily Have to Be Bigger?

asked 2 years ago by coco123 in ireland
Latest answer by Brooke R. Seckel, MD
Question viewed 2,276 times
Tags: breasts, female, 110-129 lbs, 5 ft 0 in to 5 ft 3 in, silicone implant, 200-249cc, 250-299cc, 300-349cc, B cup, high profile, hydrogel, loose, over muscle, skin

I'm standing 5'3" tall and weighing 112lbs. I had 230cc hydrogel breast implants 10 years ago in front of the muscle. I went from an AA cup to a B cup. They will be replaced by silicone high profile behind the muscle.

My plastic surgeon says I will need to go from 230cc now to approximately 260cc-300cc this time to ensure I'm not left with any loose skin underneath the implant. I like the size I am now and dont want to be noticeably bigger. Is it possible I would have to go to 300cc to get the job done right and would this be much bigger than I am now? Thanks.

13 answers to Does Breast Implant Replacement Necessarily Have to Be Bigger?

Placing an implant under the muscle compresses it more than on top of the muscle

If you're going from a submammary (above the muscle) to a subpectoral(beneath the muscle),the implant will be compressed more. in addition, the pocket that was made previously will not shrink down.Implants placed under the muscle tend to sit higher on the chest than implants placed on top of the muscle. If you want to stay the same size, you need to understand that there may be some sagging of the skin and that you may need some skin removed from around the areola. Otherwise, going with... more

Joseph M. Perlman, MD
Houston Plastic Surgeon

doctorperlman.com

Breast Implant replacement and sizing

Your surgeon has chosen to place the new implant under the muscle. This is a wise choice for several reasons. First, if the implant is placed under the muscle, it has an extra layer of protection which will make the implant feel and look more natural than if placed above the muscle. Secondly, you will eventually need to have a screening mammogram. It is much easier to see the breast tissue if the implant is placed behind the muscle. However, if the implant is placed behind the muscle,... more

Michael A. Jazayeri, MD
Santa Ana Plastic Surgeon

Circumstances change, so can the implant when exchange is needed

Many years after breast augmentation the breast tissue can thin or the breast may droop over the implant. Also in the case of a silicone gel breast implant, leakage can cause a capsule contracture to set in, or cause calcifications in the breast capsule which must be removed as the implant is exchanged. After menopause the breast may have become larger as the fat content increases. All these factors, as well as just wanting to be a little larger, or a little smaller influence the size... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

www.peterejohnsonmd.com

Replacement or Exchange of Breast Implants are Usually Bigger

In almost all cases when an exchange of Breast Implants is done a larger size Breast Implant is placed. This is primarily because over time the Breast Implant has stretched the pocket the implant is in, the breast tissue, and the overlying breast skin. If the same size breast implant is placed there is a risk that the implant and the breast will sag or drop down. This is especially true if you are converting from over the muscle to under the muscle. Of course if you want a... more

Brooke R. Seckel, MD
Boston Plastic Surgeon

www.drseckel.com

Increasing implant size for a revision

Your surgeon seems to think a larger implant will allow you to have a similar looking breast and avoid a lift which would be required for sagging skin. I use this concept often in patients who really don't want the incisions for a lift and are borderline for needing one. I'd say the change to 260cc would be barely noticeable and the other sizes would only increase a little. Since the implant will be moved subpectoral the implant will probably seem a little smaller and less mobile. Best... more

Mahlon Kerr, MD
Austin Plastic Surgeon

Breast implant size

It is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired... more

Tom J. Pousti, MD
San Diego Plastic Surgeon

Breast Implant remove and replace: size

SEE VIDEO BELOW: Generally speaking, most patients who request implant removal and replacement desire larger implants and that is why, I presume, you are asking. However, I occasionally see patients desiring implant removal with smaller implants. Most of these patients are pleased with their decision and a few have come back for complete removal without replacement. The overiding concern is whether to perform a lift and generally I advise patients not to do a simultaneous lift unless their... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

Do replacement implants have to be bigger.

Hi Coco123. Why are you switching position of the implant? I would like to have that information. If you can stay on top of the muscle, choose an implant that has dimensions that are similiar to the one you have. If you have to go under the muscle, I agree that the same size implant you have now will probably look smaller under the muscle, so you have to go a little bigger to maintain the same size visually. I am concerned that the doc said he is going bigger to prevent loose skin. Is... more

Tracy Pfeifer, MD
Manhattan Plastic Surgeon

drpfeifer.com

Breast implant exchange

It would be difficult to tell without examining you. But it is not uncommon to go a bit bigger especially if your breasts are a bit saggy.

Steven Wallach, MD
Manhattan Plastic Surgeon

Breast Implant exchange

I would agree with your plastic surgeon. Going under the muscle will make the larger size implant look smaller. In addition take a look at the actual size difference in the implants. It really is not that great an amount. Your final decision should be a joint decision between you and your plastic surgeon. he/she should be able to explain to you with clarity why you should choose the size he is suggesting.

John P. Stratis, MD
Harrisburg Plastic Surgeon

Breast Implant Removal and Replacement

The decision to increase or decrease the size of a new breast implant is dictated by patient aesthetics and the amount of resiliency of the breast skin envelope. An increase in volume of 50 cc will not significantly alter the appearance or volume of the overall breast but may better fill the breast envelope.

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

Exchanging breast implants

From your description, to go under the muscle with the same size implant as you have now will result in a smaller size than you currently have. You need a bit larger implant and might consider an adjustable saline implant that can be altered for months after surgery to get the exact size and look you want. Also, consider a lift if your skin is loose and the nipple is too low.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Bigger breast implants for replacement

The simplest analogy to your question is to look at a sailboat. When the wind fills the sails fully, they do not sag. When the wind slows, the sails slack and went the wind goes away, the sails will sag completely. The PERKINESS of the breasts is determined by a ration of the amount of breast skin (IE Sail) to the amount of breast FILL (breast tissue AND implant volume and projection). The Implants you had until now no doubt stretched your skin somewhat. Were to to exchange them with the... more