What Size for Breast Augmentation Revision?

I had breast augmentation a year and a half ago. i feel like my implants are getting smaller every day. I now wear the same bra size i wore before my surgery, which is A-Cup. i have implant malposition, scars are too low as well. the implant is placed underneath the muscle. i have 275cc anatomical implants. I want round 450cc implants (C-Cup) at least, but my surgeon doesnt want to give me more than 350. what do you think?

Doctor Answers (11)

Sizing for reaugmentation.

+3

Thank you for the photo and your description. Based on your photo, you appear larger than an A cup breast. You mention that the scar is "too low." It appears to be just above the fold, which is the proper position for the scar. Overall, the implants appear to be in good position and give you a very natural breast shape. However, with one photo and your body at an angle, it's difficult to judge position. Regardless, it sounds as though you wish to be larger. A short review of sizing may help to clear up why your surgeon says 350cc despite your request for 450cc.

When sizing an implant, the goal is to measure the breast and choose an implant which does not distort the natural anatomy, but rather "augments" the breast to a larger size. The most important measurement is the base width of the breast. This is the inner and outer boundaries of the breast. If an implant is placed which is wider than the width of the breast, issues with malposition, rippling, thinning of breast tissue all become much more common. A 450cc implant is considered a large implant, and would likely give you a D cup breast rather than a C. (Cup sizes vary considerably between bra manufacturers. Unlike the chest wall circumference, there is no standard, hence why no surgeon will ever "promise" a cup size.) If your plastic surgeon is warning you against a larger size implant, I would heed their warning.

Web reference: http://www.drbogue.com

Boca Raton Plastic Surgeon
5.0 out of 5 stars 8 reviews

You have a good result but want a great result

+2

You have an excellent result with slightly low implants but my guess is that you have a relatively long torso and your crease was low set to begin with. You likely would get an excellent result with 450 cc round smooth silicone moderate plus or high profile implants. However you must be willing to accept the risks of surgery.

Web reference: http://www.bodysculptor.com/breast-surgery-chicago/

Chicago Plastic Surgeon
5.0 out of 5 stars 39 reviews

Breast implant sizing

+1

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 cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the press implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.

Web reference: http://www.poustiplasticsurgery.com/Procedures/procedure_breastrevision.htm

San Diego Plastic Surgeon
5.0 out of 5 stars 624 reviews

Revision augmentation

+1

To determine the appropriate implant to place in the pocket really depends upon your  anatomy and your goals. I couldn't say for sure without an exam. Good luck.

Manhattan Plastic Surgeon
4.5 out of 5 stars 14 reviews

New size with implant revision: How to decide?

+1

Ignore cup size, it isn't a very consistent way of measuring breast volume. This is especially true in chosing implant size, which is very subjective anyway. The new size will be limited by the base diameter of your breasts, which your surgeon should measure and then discuss what this means in terms if implant volume and how it affects the location of the scar.

Seattle Plastic Surgeon
4.5 out of 5 stars 21 reviews

Be careful about any revisional breast augmentation surgery.

+1

The scars will continue to improve.  Your breasts are not getting smaller but it sounds like you would prefer larger size.  If there is asymmetry, the photo doesn't show much.  If your breasts are soft, I would think carefully about any sort of revision. 

Web reference: http://www.zubowicz.com/subpag,13-atlanta-breast-augmentation.htm

Atlanta Plastic Surgeon
4.5 out of 5 stars 6 reviews

Going Larger with Breast Implant Revision Surgery

+1

There are two issues here. One is choosing the right implant size and the other is the scar location. First and foremost, the size of the implant should be based on several factors, such as the natural width of your breast and the quality of your skin and tissues. If you choose an implant that is too large for your breast, then you will have problems down the line. In determining the best size for you I would primarily rely on the base diameter, or width of your breast. I would not want to use an implant that is wider than the natural width of your breast, This can be manipulated somewhat by using a higher profile implant.

The second issue you raise is scar position. Your incision actually looks like it is in the proper location. So in short, I feel your surgeon executed the surgery well, but you could stand to go larger in the implant size as long as the implant meets the dimensions of your breast.

Hope that helps and good luck!

Los Angeles Plastic Surgeon
5.0 out of 5 stars 6 reviews

Larger implants in a revision surgery

+1

The way you have assessed your situation is well thought out.  You absolutely could have 450cc implants.  The best choice is smooth round gel and depending on the size of your chest wall then you may want either moderate profile or high profile implants.  You have to decide if a little too much breast under your armpit would bother you.  Your mal-position is a contraindication of shaped implants and the scar being too low may come up just a little with larger implants stretching the skin. 

Folsom Plastic Surgeon
1.0 out of 5 stars 1 review

How to pick breast implant sizes

+1

1) This is the most common type of question on RealSelf.

2) It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical.

3) Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like.

4) Then your surgeon has to tell you if your chosen look is realistic for your anatomy. The most common mistake is to go too big.

5) I recommend that the surgeon NOT make a final implant choice in advance, because this is just an educated guess.

6) The surgeon should have a large inventory of different size and shape implants available in the operating room.

7) Then the surgeon can put sterile disposable implant SIZERS in your breasts during surgery, to see what a particular implant really looks like inside you. This is how to make the best choice. A sizer costs only $45, and takes all the guess work out.

8) Finally, the sizer is discarded, and the correct breast implants (based on what you want and on your anatomy) are opened from the operating roon inventory, and put in your breasts to complete the operation.
 

Manhattan Plastic Surgeon
5.0 out of 5 stars 9 reviews

Breast Implant Revision

+1

Your implants look slightly low, but overall your result is good in this photo.  Bra size is very subjective and depends on the bra maker and bra type, but you look bigger than an A.  That said, sure you can go bigger but your surgeon's cautious advice has to do with going significantly bigger on your frame, which I'm guessing is somewhat small.  There are issues of tissue compliance, skin stretching, chest wall distortion, going with big implants that you should discuss with your surgeon.

Santa Barbara Plastic Surgeon
4.5 out of 5 stars 18 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.

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