Unhappy With Implant Size- Doctor Made Choice Without My Consent

i had BA & requested a largeC or small D, dr made me large B, stated risks of bottoming out. Why didnt he tell me from beginning??? I didnt want small unoticeable implants. Then when i asked about enlargening them he said after 6 months its possible depening on my skin. He taped me in the center and said because i almost bottomed out. I paid 6000 for this! Is this fair practice? Does he have right to charge me for revision??? To enlarge them?

Doctor Answers 12

Relation between Implant size, Breast size and Bra size in Breast Augmentation

The cup sizes are not standardized and are different from one manufacturer to another and different from one model to another. The volume of breast implants are measured by “cc”or “ml” and there is no correlation between cup size and “mI”. The same size implant in two different patients even with the same cup size breasts could result in completely different cup size, because there are a lot of variable such as the size and shape of the breast, shape and width of the bony chest, elasticity of soft tissue, amount of loose skin and width of the breast base. Also there are limitations as to how large an implant you can have based on the location of the implant( above or under muscle), on the amount of loose skin, elasticity of the skin and soft tissue and the width of your breast base.

It does seem like there was some breakdown in communication between you and your plastic surgeon. It is reasonable to wait 6 months before going larger to allow the tissue to stretch. Regarding the charge for the second surgery, you should work that out with your plastic surgeon, but you should understand that with any surgery there are some expenses(new implants, anesthesiologist, medical and surgical supplies, outpatient facility charge, etc.)


Jacksonville Plastic Surgeon
5.0 out of 5 stars 24 reviews

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Unhappy with implant size

It sounds like you are having a tough time with your postoperative course.   It's not uncommon for patients to be disappointed with their breast size, and sometimes it's just a matter of waiting long enough for the healing process to occur, swelling to subside, implants to drop, and the immediate postoperative stress to resolve.  However, it may be that the communication between you and your surgeon wasn't sufficient - it's difficult to guarantee bra sizes since most women can comfortably wear a couple different band/cup sizes and not all bras are the same - and there are many reasons to not put in large implants from a technical perspective, depending on your body.   I would recommend talking with your surgeon about your concerns until you feel comfortable, or asking him to recommend another opinion!

Revision costs.

It is important for your doctor to inform you of things and for you to discuss size and options prior to surgery.  Some doctors will charge a fee for revisional surgery and others don't- it's very dependent on the surgeon.  You should read consent form that you signed before your surgery- these issues were likely discussed in that document.

Scott E. Newman, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 29 reviews

Not happy with Breast Implant Size

With breast augmentation surgery, it is NOT POSSIBLE to guarantee a specific cup size or cc amount.  The surgeon has to make decisions after examining you and knowing your goals.  There are many factors involved with how large you can go during surgery.  I ask patients to bring in photos of their "desired look" because I feel that this type of communication is MUCH MORE clear than "C cup" because different sizing is different when you try on different bras.  I don't know how far out from surgery you are but allow yourself time to heal, for the implants to settle, etc. before determining that you are unhappy.  After 6 months or so, if you are still unhappy, have a discussion with your surgeon.

Too small after augmentation

Volume and skin must be in balance.  If you have a small skin envelope your surgeon may have felt limited in terms of the volume that your skin envelopes could safely (and aesthetically) accommodate.  Your surgeon should have taken time before surgery to make sure that you were on the same page.  If you are now dissatisfied the only charge for revision should be for anesthesia and surgicenter.

Please send your pictures

You  are not happy with the size and you are not alone. The problem is the patient expectations and the limitation of the breast tissue. I do not see any reason that your surgeon would place smaller implant than you wanted . Please send more information about your implants and your before/after pictures

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 70 reviews

Unhappy breast size after breast augmentation

Clear communication is the key to the look you want after breast augmentation, though it is the surgeon's responsibility to choose the implant size which will get you where you wish to be, yet stay out of trouble with high, bottomed out, or a 'double bubble' breast. We would like to think that you doctor placed your interest first, and you should spend more time with him to help understand where you have fallen short of your goal, and what the chances are of a safe or meaningful revision if you wish.

Best of luck,

peterejohnsonmd

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 33 reviews

Unhappy with Breast Size After Augmentation

I am in agreement with most plastic surgeons who believe that it is not possible to predict or promise an exact cup size because there are too many variables. Also there are limitations as to how large an implant you can have based on the amount of loose skin, elasticity of the skin and the width  of your breast base. It does seem like there has been some breakdown in communication between you and your plastic surgeon. Don't expend a lot of energy being angry. Go and talk with your surgeon again and bring pictures of the size you would like although know ahead of time that not all things are possible. See if you can work out a solution for a revision that is satisfactory. There are no set rules for charging for revisions, only what you have discussed and agreed upon. If you are still not happy, then go and get another opinion from two plastic surgeon and see if you hear anything different.

Joseph Fata, MD
Indianapolis Plastic Surgeon
5.0 out of 5 stars 67 reviews

Breast Augmentation and cup size

It seems that you may have had a communication with your plastic surgeon.

Breast Augmentation surgery is not an exact science and it is difficult to predict cup size.  Bra cup sizes are not objective measurements and implant sizes will produce different cup sizes in different patients.  Every effort may be made to try to come as close as possible with preoperative and intraoperative sizers but this may still not correlate with an exact cup size request.  Have an honest discussion with your  plastic surgeon regarding these issues. 

Stephen Delia, MD
Boston Plastic Surgeon
5.0 out of 5 stars 11 reviews

Breast implant size vs bra size

It would be helpful to see some photos, but you did not mention your implant size. We seldom like to talk about bra cup size since there is such a huge range of variation in cup size for a given size breast. For example, I have placed implants in the 275 cc volume increasing the cup size from A to C. And others where a 300 cc implant increased the cup from A to DD. Now I cannot see how this is possible. But this is what patients have told me. It is important to be on the same page regarding how much larger a patient wants to be, regarding the implant size, and understand that cup size is never a guarantee.

As far as revisions are concerned, you need to discuss this with the Doctor and his staff to find out what the office policy is for revisions. Typically there are costs relating to increase in size after augmentations.

Victor Au, MD
Chapel Hill Plastic Surgeon
5.0 out of 5 stars 7 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.