What is the maximum size implant that can be placed safely behind the muscle for silicone memory gel? Also I know that a cc is a cc but in saline implants have a different shape and appearance compared to silicone memory gel. I had saline implants 375cc went to silicone 500cc but they seem smaller is this possible?
What is the Maximum Size Implant That Can Be Placed Safely Behind the Muscle for Silicone Memory Gel?
Doctor Answers (19)
Should have taken you up about 1/2 cup size
It is possible that the change in size that you are noticing is actually a change in shape. How does your breast fill the bra following the use of a larger implant? A change of 125 cc should have taking you up about 1/2 cup size. In my experience, when a patient desires to be a larger size and we have to use a new implant I usually want at least a full cup size difference to be present.
It is important that you make your desires known to your surgeon. Pictures of what you want to look like are a big plus. I never allow a patient to say, " I want to be a full C." It is hard to know exactly what they are talking about.
Most of the early revisions for breast augmentation surgery are for size problems. It is expensive to make this mistake and it all comes down to communication. You have to make your desires and expectations clear in order to get the result that you were expecting. No one wants a disappointed patient. Too big, too small, or just right is an individual choice. Pictures help to make your point clear.
Some factors to consider when choosing best implant size
Choosing the best size implant depends on a number of factors. Patients' preference is at the top of the list, however, when choosing large implants the skin envelope is a primary concern. Going too big can permanently disort the breast tissue if the skin envelope is too small. For an average sized woman anything over 350 cc risks that type of damage. The largest silicone implant made today is around 800 cc. There are no hard fast rules. Discssing your options with an experienced breast surgeon is your best .bet. It is true that sometimes switching from a saline implant to lower profile silicone implant can appear to be smaller even if it is a larger volume implant. Projection (implant height) does make a difference.
When choosing breast implants, common sense must prevail
Mentor Corporation manufactures the MemoryGel breast implants. With respect to size, there really is no limit as custom implants can be obtained through you plastic surgeon. However, I must emphasize that common sense must prevail; don't assume that bigger is always better! Implants that are too large may upset the natural beauty and balance of your figure. The appropriate choice of implant size and shape does not need to be complex as it should be based on your physical dimensions and proportions. A potential breast augmentation patient needs to include in her decision process factors beyond just appearance, looking at her physical activities, lifestyle, hobbies, and vocation.
In summary, it is best to see a board certified plastic surgeon that is experienced in breast surgery. Do not be in a rush, and be prepared to engage in thoughtful dialogue and discussion. After all, it is all about you!
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There is no "Maximum" implant size
The decision about implant size depends on many factors. The size of your chest, body type, base diameter of your breast, and skin quality all help to determine the "optimal" size for you. This size might be very different for another woman. There are also many ways to help you to determine what implant size would fit you well. Some plastic surgeons have "sizers" in their office that they will fit into different size bras so that you can begin to see what kind of a change you would get with different size implants.
Other ideas are for you to use water or rice in sandwich baggies in a bra of your choosing at home, and then try on different kind of clothing to determine what looks best. Sometimes, if a woman is having a very hard time deciding on size, I have her bring in the bra she would like to fit into after the surgery, we sterilize it and use it to size her in the operating room. In your case, you may be noticing a change in shape, more than a change in size.
I have had a number of patients swap out saline implants for gel and have the same impression that you have. Typically these are patients who loose some fullness in the upper part of their breast as the implant in replaced in a more "natural" position. Hope this information is helpful!
The operative word is "safely"
This question really depends on your definition of "safely." In terms of risks of the implant material to your health, they are the same for all implant sizes, so the largest available implant (800cc) can be used "safely". In terms of risks to your tissues, breast sensation, breast feeding ability, implant complications, etc., the larger the implants, the greater the risk. So, the idea of "safely" depends on your tolerance of complications before YOU determine that the procedure is unsafe.
Silicone gel implants are less projecting than saline implants. This may account for your 500cc gel implants seeming smaller than your 375cc saline.
You don't want the maximum size.
Hi! You could have 500 cc to 700 cc implants put in (depending on your anatomy) and you would get away with it. But I really don't recommend this. Huge implants don't look natural, they have more problems (for example, increased risk of loss of nipple sensation), and they don't age well. If a woman insists on implants that are too big for her, I will not operate on her.
1) The final decision on implant size should only be made DURING SURGERY, not in advance. ( Of course I must understand what you want and we make a tentative choice before surgery.) We put the operating table into a sitting position (you are under anesthesia, of course) and we place temporary implant SIZERS into the implant pockets.
Then we try different amounts of saline inside the sizers until we find the largest size that looks natural. This takes the guesswork out. Then we select the corresponding silicone implant and the sizer is discarded.
2) A silicone implant will look about 50cc smaller than a saline implant of the same size.
To avoid multiple reoperations base your implant selection on your breast tissues
I am a firm believer in Tissue Based Planning principles. There is a growing group of plastic surgeons across the world that believe a 30% reoperation or revision rate 3 years after surgery for: size change, poor position of the implants, stretching of the skin etc is way too high. If a breast implant chosen is based individually and in a customized way to fit each patient's breast, based on a few basic measurements and assessments such as breast width, stretchiness... and an implant is designed to fit in this range, the results are very consistent, full and natural and do not produce stretching or problems and can lower the revision rate to 3-5% at 3-5 years. If any implant size is chosen, eventually it will place tto much pressure on the breast and skin and thinning of the tissues, increased malposition, wrinkling and rippling etc may occur.
You are correct most patients and even some plastic surgeons do not understand that saline weighs slightly more than silicone, not less. In addition a saline implant is filled in surgery and does not include the weight of the shell of the implant...verses a a silicone implant that is prefilled and its' shell is included in the weight...so when I replace a 300cc saline implant filled to 330cc's it actually weighs 350grams/cc's so we need to replace with a 350cc implant just to get back to baseline.
Finally the most common misunderstanding in choosing an implant size is that implants come in 30-40cc increments...patients cannot really tell the difference inside the body, particularly submuscular, between a 300 and a 360cc implant although 360 sounds a lot bigger. We have to add 100-150cc before you really begin to recognize the difference.
Personally I rarely place implants, even in revision patients > 500cc...ususally this outweighs the tissues and further problems can occur. To directly answer your question, a 500cc implant is certainly larger than 350, but if you had prior saline implants your implants probably weighed 370-380cc bringing them closer to 500cc/grams. Most patients can tell between implants 100cc or greater...if your weight has changed this can also affect your breast size.
Hope this helps.
Limitations have to do with anatomy and implant dimensions
Generally, I believe that implants should be chosen based on a patient's anatomy and the implant dimensions. If you are interested in a more unnaturally large breast contour, certainly larger implants could be placed, as long as you understood the aesthetic outcome likely, and the longer term risks of implants that are larger than recommended, such as the risks of skin thinning and stretching (requiring a subsequent breast lift procedure).
In this case, the limitations would be the expansibility of your skin and the upper limit of implant manufacture. The largest readily available gel implant is filled to 1000cc, but a larger one may be custom made.
Depends on every patient
The largerst silicone implant made by the company that I personally use is 800 cc. And that is the memory gel. Now there are companies out there that custom make implants as well.
As far as how large one person can go strictly depends on the patients body habitus, measurements and so forth. So impossible to tell how large you can go without an exam.
As far as silicone and saline equivalent, you are right a cc is a cc. It also depends on what time of implant, some have more projection than other given a set cc. So what may appears larger may simply be that the saline implant may have had more projection than the silicone implant, which may be wider.
Hope that helps.
Best to answer this in person
The nature of the questions you are asking can only really be answered by a plastic surgeon in person. In general though, there are different implant shapes and profiles that can make one implant look very different from another regardless of the volume in the implant and whether it is saline or gel. Also, the volume you can place behind the muscle is really dictated by your body dimensions and the nature and quality of your tissues. Perhaps you should visit a few plastic surgeons in NY and ask them directly. Many provide excellent answers on this web site!