I have 425 saline mentor mod profile implant filled to 450 on right and 490 on left. My left on is pretty firm, bigger and lower then the right. It really bugs me. I dont even like to look at my breast anymore. Theres a big difference even with my clothes on. My left breast is round and sticks out more. My doctor says they look okay but every one that has seen my breast ask why im much bigger on one side. Can i have another sugery to remove ccs or do i need a new implant?
Can Cc's on Breast Implant Be Reduced After Surgery? My Surgery Was 2 Months Ago.
Doctor Answers (3)
Decrease in saline implant volume with re-operation? Yes, but only a bit.
Your surgeon used identical saline implants filled to different volumes, likely because of a perceived pre-operative difference in breast sizes, or perhaps during surgery if one side looked different from the other with similar fill volumes. Whatever the reason, most surgeons know that if a woman's breasts have similar size pre-operatively (nobody is exactly symmetrical), then identical implants should preserve, and actually improve, symmetry. "On-the-fly" decisions tend to have higher likelihood of being incorrect, but are sometimes still necessary. Experience plays a role here.
Unfortunately, symmetry did not happen with your surgery, despite the fact that a 40cc final volume discrepancy is really quite small (less than 3 tablespoons). However, saline implants come in size gradations less than this volume, so the decision to fill the implants differently seems to have been one made in the operating room. Saline implants come in so many different sizes because of the fact that the feel (firm or soft) and degree of rippling or edge feel can vary with only slight fill volume differences. "Proper" fill for saline implants is approximately 10% over the nominal implant size (for a 425cc implant fill will range from 425cc to about 470cc or so, dependent upon each individual patients tissue characteristics found at surgery. So, your 490cc fill volume COULD be decreased by 40-65cc or so and still be in proper range, but anything more than this would better be done with a different implant filled to its "ideal" volume to achieve better symmetry.
So your surgeon was "spot-on" with the 450cc fill, but perhaps a bit too much with the 490cc fill volume. Excessive firmness could be one result of this degree of overfill, and yet most patients would not be able to see a 40cc decrease in size from a "too-large" result.
I must stress that fill volume is something every surgeon must decide at the time of surgery, and there is no precise right or wrong. Yet our patient's happiness is a direct result of these decisions, and the choice to re-operate is not one to be made lightly. There could simply be more swelling in your right breast (which can be expected to settle over time in most cases), or perhaps bleeding that went unnoticed. Early capsular contracture is another (unlikely, but possible) cause of the difference in firmness and size.
Certainly you can have another surgery, and you and your surgeon should be prepared to use a new implant if that is required. It is by no means a foregone conclusion, however! It would be best to wait until things are really settled, so that any differences are true differences rather than swelling, etc. I'd recommend a minimum of 3 months; 6 months is better and more likely to result in only one further operation. Too-soon re-operation increases the risk of not hitting the "moving target" accurately. Best wishes!
If the larger one was overfilled, it certainly can be deflated a bit, but remember going back in, may cause the implant to be damaged during surgery. Good luck.
Removing Saline from Breast Implant?
Thank you for the question.
You will find that different plastic surgeons will feel differently about deflating a saline breast implant to some degree. Some plastic surgeons feel strongly that manipulation of the breast implant valve may cause injury to the valve and a greater likelihood of leakage of the breast implant. Some surgeons, on the other hand, would feel comfortable removing some saline (while staying above the breast implant manufacturer recommendation fill volume).
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