Advice for Too Small Breast Implants?

Thanks for your question.  I am sorry to hear that you are unhappy with your breast implant size.  I believe in doing detailed breast measurements before surgery with all my patients.  I always have patients try on implants to get some idea about size and their goals and wishes; however, I believe that the breast tissues and measurements (i.e. width of chest, distance from the nipple to the crease under the breast) really are the most important factors in selecting breast implant size for a good result.  Just like fitting a shoe to someone's foot, I believe, a breast implant has to be carefully selected to a patient's tissue dimensions.  Saline breast implants can "exceed" natural breast tissue measurements more than silicone gel breast implants in general because they are placed into the pocket "uninflated".  Sometimes when "too much" saline is placed into too small of a space, it imparts even more tension on the overlying breast tissues creating a very unnatural and high breast implant that can be very uncomfortable, cause the patient to have a very lengthy recovery from surgery, and even sometimes "stay" too high in a malpositioned location.   I believe, the breast tissues dictate "how much space" there is "available" for any breast implant. Exceeding natural tissue measurements increases the chance of the need for revision breast surgery.Sometimes it is not possible to exactly achieve a patient's goals and wishes (in one surgery) based on their anatomy.  It sounds like you may have saline breast implants and many times when they are filled to volumes that exceed a patient's tissue measurements, there can be a higher incidence of breast implant malposition and even capsular contraction as well.  Typically a bra cup size "equates" to about 200 ccs so there should be a cup size improvement depending on the bra that you are trying on.  The implants will often look "high" when they are under the muscle for some time. It can take 3 months or more for the implants to "drop" at times. I usually, recommend bandeau straps and implant-displacement exercises to my patients to facilitate this, but this is something to specifically ask you plastic surgeon about.  In general, you can always "go bigger" after 6 months (although I think it's better to wait a full year before considering) re-augmentation.  I hope this helps.  Good luck! 

Sorry to hear that you're disappointed in your results. We use a specific sizing system to try to limit problems such as yours and, so far, we have. I'd talk with your surgeon about your expectations and, hopefully, he or she will be receptive to your comments. Good luck

Hi Dru, I'm so sorry to hear of your situation. I'm not sure what was lost in translation based on what you requested as an outcome and what you received. Every surgeon uses a different angle when working with patients to determine what size implants will give them the outcome they want. I am a fan of The Rice Test and "Wish For" photos from patients. These tell me exactly how much volume they are comfortable with and what they're picturing for themselves. 
I would voice these concerns with your surgeon and see if you can't come to some agreement. A revision to go up in size should be relatively simple. My first thought was they were limited with what could fit, but 300cc's is not a very large implant. (Should you be disappointed with your 600cc implants, I might say this was the reason.) I will say patients focused on a bra size often end up with outcomes they are unhappy with and don't understand why they don't look the way they thought they would.  My best advice is to be concerned with what you look like with a specified amount of added volume, not what that exact volume is. What cup size or implant size you end up is really not as important as how happy you are with what you look like. Show your surgeon what you are visualizing for yourself with photos of other patient's outcomes and open the lines of communication. Try the Rice Test and tell them the volume you'd like added. Good luck to you.