2nd time around Dr is telling me I have to go bigger to achieve same size

After 10yrs and a baby I have decided to have my breast done again. I am having a breast lift done along with replacing my implants. I would like to remain the same size but my Dr. said that in order to be the full C that I am he will need to increase the implant size. I am confused and nervous why he would need to. Has this happened to anyone else? My Dr. is also saying that in order to achieve a good outcome I will need silicone opposed to the saline that i currently have. I am VERY nervous about getting silicone implants. Any advice/opinions anyone has would be greatly appreciated.

Doctor Answers (5)

He might be right...

+1

If you were considering the change to silicone implants (don't do it if you're worried about it), then it takes a slightly larger silicone implant to give the same projection as a saline implant.  So going to a bigger implant is one way to achieve the same look.  Also, the lift (and it depends on the type of lift you need) may give you the feeling that you are smaller after surgery.  Actually, you are not smaller, you will just fit in to a bra differently so your cup size changes.  For that reason you may consider a slightly larger implant (something like 50-100cc larger, not huge).  None of us have seen you to know what you look like so your surgeon may be on the right track.  Go get another opinion.  If it differs drastically from your first, then go get a third.  Don't make a decision you will regret later!  Good luck.
 


Columbus Plastic Surgeon
5.0 out of 5 stars 8 reviews

Implant size and type

+1

I would agree with Dr. Baraka. There is only one situation where a somewhat larger implant is needed in order to look the same size and that is converting an augmentation implant from above the muscle to below the muscle. Even this is a perception rather than a true size issue. I suspect that you are being misled by the misconception that a larger implant is needed in order to lift the breast. 

A lift is really only needed when the nipple-areola is too low relative the base of the breast (where the implant is positioned) and the inframammary crease level. It is possible to raise the nipple-areola and the breast behind it to a higher level without changing the existing implant. Nearly always this can be done with a lollipop incision. If the nipple-areola is not too low relative to the inframammary crease, it is possible to adjust the position of the implant down somewhat. In that option, the top of the implant will lower as well and the upper pole of the breast might scallop out more. In this case a wider/taller round implant would compensate and this would be a larger implant but because of the width/height rather than volume per se.

The choice of saline-filled vs. gel-filled implant should be up to you. The only advantage to the gel-filled implant is feel if tissue coverage is such that you can feel it. If you're doing okay on that with the saline implants you have then there's no reason to change to gel. Saline-filled implants have a number of advantages over gels including that you don't have to worry or wonder what condition they're in or get any tests done. If you're worried about silicone gel then stay with saline and avoid this issue. 

Scott L. Replogle, MD
Denver Plastic Surgeon
4.0 out of 5 stars 1 review

Dr is telling me I have to go bigger to achieve same size

+1

RE: "After 10yrs and a baby I have decided to have my breast done again. I am having a breast lift done along with replacing my implants. I would like to remain the same size but my Dr. said that in order to be the full C that I am he will need to increase the implant size. I am confused and nervous why he would need to. Has this happened to anyone else? My Dr. is also saying that in order to achieve a good outcome I will need silicone opposed to the saline that i currently have. I am VERY nervous about getting silicone implants. Any advice/opinions anyone has would be greatly appreciated."

Quick answer - You do NOT need larger implants.

Explanation - your pregnancy resulted in a larger amount of breast skin and as a result the breasts are sagging. IF you are happy with the appearance of the breast, ALL you need is a breast lift. Period.
- Your saline implants do not need to be replaced because they are 10 years old if they are intact.
- If you wanted LARGER breasts, you would benefit from a larger implant. A silicone gel implant is lighter and ripples less than a saline implant of the same volume. They are perfectly safe and are much more commonly used in Europe than saline implants. Have a larger implant put in ONLY if you want to be larger and be aware that the larger the implant, the more weight in the breast and the faster the breast will sag again.

Good Luck.

Dr. Peter A Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 66 reviews

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You can use saline and same size

+1
Going with the larger implants will increase the risk of sagging and complications. The recommendation of the silicone implants is based on the thickness of your breast tissue and your expectation regarding the softness and the rippling. You can have have saline implants and the same size.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
5.0 out of 5 stars 60 reviews

Breast augmentation revision works with same size implants.

+1

Hi.

1) I don't understand either.  You don't need larger implants unless you want to be larger.  A well done breast lift does not make you smaller.

2) Use saline implants.  Do not put anything inside your body that is going to make you worry.  We have hundreds of patients with saline implants who are perfectly happy.

3) The breast lift is done just with a scar around the nipples if the sagging is not too bad or with lollipop scars for severe sagging.  It is important to do the breast lift internally instead of just tightening the skin, because skin stretches and you don't get a good long term result that way.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
5.0 out of 5 stars 9 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.