Breast Implant Redo - Will Larger Implants Look Higher and Fuller?

I have had these current breast implants 425cc Saline for about 14 years. I feel they are too low for my taste. There is nothing wrong with the currents ones I just don’t like them. This decision is hard on me due to family and friends saying I do not need the surgery. I have had a consultation before and the physician said that if I go up to a 500cc to 550cc saline that he can get them higher and full again....what are your thoughts

Doctor Answers 25

The 425s have it

Dear Pembroke,

I don't know how old you are, but those implants look pretty darn good and quite natural.  We have a saying in Plastic Surgery, "perfect is the enemy of good".  You look better than "good" as it is, so don't look for perfection.  You might not like what you find.  Good Luck!

You may find short term happiness

What you are asking your surgeon to achieve is one of the commonest requests in redo breast surgery.  Increasing implant volume will make you happy while the new bigger implants are tight relative to your skin envelope.  This will last perhaps a year or two at best.  After that you will have bigger implants in the same position as your existing implants but with a greater problem with more stretched skin.  The only solution I've found that works to do what you're looking for is to change to a textured implant which sticks to the tissue and therefore descends less with time together with a breast lift.  This choice involves a lot of compromises and my guess is that you're better to leave your breasts as they are.

Good luck.

Nicholas Carr, MD
Vancouver Plastic Surgeon
4.0 out of 5 stars 12 reviews

The bigger they are, the harder they fall (breast implants, that is)...

I often explain to my patients that I can remove extra skin in the breast, which will change the skin QUANTITY.  But I can't do anything about their skin QUALITY.  If skin has lost some of its elasticity, then using a larger implant will be a very short-term "fix".  Looking at your photos, I believe you need a breast lift.  I would not use a larger implant (unless you really really wanted it, even after hearing the risks). 

Upper pole fullness is something most women want, but it's truly not something found in "real" breasts.  You can achieve that look with a good bra, fortunately.  A bigger implant will get you more upper pole fullness, but only temporarily, as your skin will settle and stretch.  For now, I would recommend a breast lift with the same implants (or new ones in the same size).

Carmen Kavali, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 26 reviews

Implant exchange vs. lift

If you feel that your breasts are hanging to low after having them for a number of years you may want to consider a lift. It is possible that the implants themselves will not need to be removed or replaced for this procedure. Talk with your original surgeon and ask their opinion about your situation. Bring pictures of what you would like your breasts to look like and ask your friends and family for support.

Higher fuller breasts will require a lift

In my opinion, you have an excellent appearing natural result. The size increase you describe will likely produce greater fullness but it will not likely be long lasting and may be relatively minor. If you truly desire greater fullness up top, you would  need a breast lift to reduce the size of the implant pocket in the lower portions of your breast. This will require significantly more scars and for that reason, I would adivse you to reconsider.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 56 reviews

Periareolar breast lift in Beverly Hills

In my professional opinion, increasing your breast implant size from 450cc to 500 cc would not make a significant difference in terms of lifting your breasts. Depending on if you are happy with your current breast size or if you would like to be a little bigger, you can consider changing your breasst implants to a 500-550 size and also have a peri-areolar mastopexy. while the mastopexy will help to raise your breast, it will make the breasts look a little smaller or flatter, which can be balanced by increasing your breast implant size!

S. Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 34 reviews

Breast implant Revision

An implant will not make your breast higher. Implants add volume only. Sagging naturally progresses, larger implants are heavier and may be prone to more sagging. So right after surgery with a larger implant, you will see more fullness, however, the increased weight and volume over time will aggravate your mild sagging. There is no such thing a permanent or long term superior and medial fullness.

Don't look for trouble with larger implants

you have lots of info in all the other answers so i will just throw in a brief opinion rather  than list options. it appears that you have a pleasing looking result right now, though perhaps not exactly the look you would prefer. before spending time , effort and more money, evaluate the risk you assume with more surgery vs the potential for long term my opinion it is probably not  a good idea. you are not a piece of clay that a surgeon can mold into any shape you might want to be. avoid the temptation for more surgery .....!!!!

Bruce K. Barach, MD
Schenectady Plastic Surgeon
4.5 out of 5 stars 13 reviews

Larger implants for fullness and cleavage

I agreee with the prior comment. Skin quality is paramount. I do not believe a larger implant alone will achieve what you want long term (unless you really want them bigger). You need a lift and the best way to know that is to have a side profile picture to access the nipple position.

Breast implant revision

 Much of the final “look” achieved after breast augmentation revision surgery  depends on several factors:

1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.
3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.
4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, 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 breast 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.

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.