Anxious About Size? Meet The Adjustable Breast Implant

VVartanian on 6 Nov 2013 at 9:00am

vintage cartoon woman b cup or double d?Admit it. Every once in awhile, you ditch your good intentions (and green smoothie) and slink into a strip mall for a scoop of high-carb full-fat ice cream. Once inside, the smell of sugar hits you -- and you’re positively dizzied by the rainbow of frozen choice.

And forget about selecting size — the small cup isn’t enough, the medium looks massive and the large is well, way too large.

So, as the line snakes behind you and the bored teenager holding the ice cream scooper scowls, you hastily pick a double-scoop of mint chip and instantly regret it. You walked in wanting Rocky Road.

Predictably enough, it’s fascinating (for those of us who happen to be a bit fickle) –- to find a surgical option that lets you change your mind (and breast implant size) up to six months after surgery.  Stick around for a short tour of the amazing adjustable breast implant.

Just the facts ma’am –- tell me how adjustable implants work.

woman in white satin bikini before adjustable breast implants

The major difference with an adjustable implant is that there’s a small port (about ½ inch in diameter) placed under the skin of each breast.

RealSelf member, willownwaiting, (pictured above and below), explains why adjustables were right for her: “I knew I wanted [breast augmentation] surgery, but my biggest fear was that I’d go too big.  Knowing I could start out at one size, and work my way up if I wanted to go bigger, gave me reassurance.”

"Working her way up" to a larger size involves going for implant "fills" at her MD's office --  where a needle is inserted through the skin into the port and saline is painlessly injected into the implant.

“My surgeon suggested I go with 340cc to start, giving me a ‘full C’. I think I will bump it up a little at my first adjustment,” willownwaiting says.  

The second fill, which can occur at 6 weeks to 6 months post-op - is when the ports are removed. In the MD's office once again, the chest is numbed with Lidocaine, and the ports are pulled out via the original implant incision sites.

Is it true that all adjustable breast implants are saline?

woman in white satin bikini before after adjustable breast implants photo

This is true. Which means you need to be aware that there may be a trade off (in look and feel) with saline versus silicone, says plastic surgeon, Dr. Siamak Agha.

“Saline implants will give you a more 'augmented' look. Most people come in and say they want a natural look. But, the younger population, 22, 23 or 25, often want them to look augmented [and less natural] -- they like the roundness, the fullness and the perkiness of saline. When I’m doing a mommy makeover on a 45 year-old that has two babies, it’s likely she wants silicone.”

Am I a good surgical candidate for adjustables?

Women not 100% positive about size are good candidates, but if you’re thinking of a drastic change after surgery -– (like a B cup to a triple D) that’s probably not realistic. Says cosmetic surgeon, Dr. Mario Diana, in a RealSelf Q & A: “Adjustable breast implants can only be “adjusted” by around 10 to 20% of their planned volume.”

If you have a condition like congenital breast asymmetry, you’re also an excellent candidate — as matching the normal-sized breast can be a surgical challenge.

“Sometimes it’s difficult to estimate if it’s 75, 100, 125 or 150 ccs of difference. It gives us the ability to go back [after surgery] to further correct it,” says Dr. Agha.

Lastly, it’s important to consider if you can to stick to a follow-up fill schedule (and understand that you’ll be undergoing two surgical procedures on each side).

“The only negative [issue] I have about the ports is that there has to be a second incision,” says willownwaiting, “I hope the scarring is minimal and the healing is quicker as [the new incision site] is [estimated] to be about ½ the size of the original.”

So, what's the takeaway in this quest for getting it “just right”?

woman in white satin bikini after adjustable implants

For those wanting to exercise a bit more control over their end result -– adjustables may be the way to go. Says willowinwaiting: “I wanted to know that I am satisfied 100% with their size. Unlike silicone where you either like them or you don’t … [I like most] that I have two opportunities to adjust [to a larger size].”

Does this mean it’s possible to have that lovely scoop of rocky road (and eat it too)?

To read more about silicone versus saline implants, join the discussion here!