Will 250cc Breast Implants Be Significantly Different from 350cc?

Question

I had 350cc's done about 3 years ago and have since had a baby. I hate the size of my breast.  I feel they make me look fat. I want to have them removed but, my PS says that he would not recommend it because they will look like a flat tire. He is recommending removing the 350cc's for 250cc's with a Mini lift.I am worried that will still be too big. The doctor will not do less than 250cc. Do you think that 250cc will make that big of a difference. Please help!

Elizabeth Slass Lee, MD · Answer

100 cc can make a difference in visible breast size in a small breast on a small woman. Without information about your height, weight and bra size, I don't know if you are petite or full bodied or if you wear a 34B with or a 36 DD with your implants in place.
Your posting brings up a serious question for me though, do you want implants at all any more? I have not evaluated you in person, nor do I have the information above, but sometimes pregnancy can change the shape and size of the breasts so that implants are no longer needed for the volume you want. The breasts might be droopy and need a lift if the implants are removed, but these are all issues that you should be able to discuss with your surgeon. Given the information you have provided, you might want to get a second opinion with another surgeon certified by the American Board of Plastic Surgery. There sounds to me that there should be choices than just downsizing by 100cc, but advice can only be given in person with a full consultation.

Armando Soto, MD, FACS · Answer

Hi there-
 Achieving the Beautiful Breasts You Desire!
One of the things I find most interesting is the amount of misinformation the average patient must sift through when researching breast augmentation surgery. In particular, I think that many patients become overwhelmed with implant choices and the abundance of information about these options available on the Web...
This is complicated once they contact a surgeon or two for information about the implants, and which is most likely to give them the result they desire. Somewhere along the way, opinions expressed by a surgeon are perceived as fact by a prospective patient (because of the surgeon's reputation or the apparent strength of his/her opinion), who then becomes more confused when she hears a differing opinion.
This leads to ridiculously technical questions being posted on sites like RealSelf and others, such as:
"I am 5'5", 125 lbs, my measurements are 34, 22, 36. I have had 3 babies, all by C-section, and I breast fed two of them. My breasts sag a little, but not as much as some women I have seen. I want to have a full C-cup breast. Should I get 325 cc Allergan 410 style implants, or Mentor 350 cc Moderate profile implants. Projection is more important to me than a natural shape..."
Every time I get one of these over-thought questions, I always think the same thing... ???????
Let's take a big step back from the trees here and take a look at the forrest in front of us, shall we?
Fundamentally, the reason any woman seeks breast augmentation is because she wants to achieve a certain appearance, right? Let's repeat that- to achieve a certain appearance. NOT a certain bra size, or a certain implant volume, or even a certain implant type. When  you first stared to think you might want an augmentation, you didn't think, "I would like it if I could have 350cc implants"... You probably thought, "I would love to look like that (after admiring another woman's breasts)..."
So if we can agree that what you are really after is an appearance you would be happier with, (as I always tell my patients) let's make the desired appearance the focus of our communications... Let us both ignore bra sizes (which are not standardized and the choice of which is very arbitrary) and implant types/sizes (for now)... Let's first understand what you want to look like. I think you would agree that if we are able to make you look the way you wanted to look, the letter on your bra and the number on your implant is lees important, right? Help me understand what you want to look like, and I can give you a very accurate recommendation of options for achieving that appearance- provided a careful physical examination has also occurred.
Why is the exam so critical? After all, can't we just put small implants in women who want small breasts and larger implants into those who want larger ones?
The exam is critical, because for any one particular woman, there are only a few good choices of implants available, regardless of her goals, and these options are arrived at by taking careful stock of her breast tissue, skin, and frame. In other words, your anatomy will, to a large extent, help us understand the implant options that would make you look the best. This is the "One Right Result" concept. The taking of these measurements is so important, I do it myself every time, and based on these measurements and my patient's goals, then make recommendations regarding the implant options available to her (as these options would be different for different women).
While (as with any aesthetic procedure) no guarantee of outcome can be given, you are much more likely to achieve your desired outcome if you focus on communicating your desired appearance successfully with a skilled and experienced, Board Certified Plastic Surgeon than by over-researching the implants and micro-managing the details of the surgery. In fact, I can think of no better way for you to increase the odds of you ending up dissatisfied.
So don't over-think it... Think carefully about the appearance you want, communicate it carefully to your surgeon (using photos if possible), and make sure that the implant choice arrived at by the two of you together is based on both your anatomy and your goal. You'll be happier and the process will be less stressful!

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Dear knockoutskincare,
Determining breast size during breast surgery is difficult. Most women want to have reasonable fullness but do not want excessive fullness so that they look artificial.  They best way to achieve the look you desire would be to bring a picture of what you desire for breast size and shape.  Then, have your PS evaluate your current anatomy to see if he or she can achieve that size and shape.  It boils down to valuing/trusting that surgeon's judgement.
In my opinion you have two options. The first is to remove the implants only leaving the breast with a deflated look. Possibly a lift could be done at the same time if the remaining breast tissue is not to thin. The resulting lift will make you small.  The other option is a lift and trading for smaller implant.  Trust your surgeon or visit with other board certified plastic surgeons to get their opinion. Good luck.
Dr. ES

Otto Joseph Placik, MD · Answer

Breasts that are lifted often look smaller. Combining a breast lift with a small implant such as 250 should achieve a full C-cup in the average patient. However, your alternative is to do a lift without an implant depending on the amount of ptosis present as well as the size of the existing breast tissue..

Anita Patel, MD, FACS · Answer

You will likely notice a significant difference between the 350 cc implants and 250 cc implants. It is possible to remove the implants altogether, but keep in mind that having those implants has stretched your skin, and so does pregnancy. Removing 350 cc implants altogether will result in a dramatically different breast shape and size, making you not just smaller, but possibly flatter and more droopy. This is especially true if you do not have much breast tissue and already have drooping. There are other factors involved too, such as the size of your frame, style of implant, quality of skin, etc. Having 250 cc implants will definitely look different from having no implants.
It is difficult to say without consulting with you in person what would be best, but what your surgeon has recommended sounds reasonable. Regardless of how small you decide to go, you want to have an attractive breast shape overall. Basically the options  are implant removal +/- breast lift, and implant exhange +/- breast lift. Make sure you understand the expected outcomes and limitations for each option. Once your expecations are clear to your surgeon, he or she can explain how to best accomplish your goals. If you are uncomfortable with one surgeon's recommendation, consider seeing another board certified plastic surgeon for a second opinion.
Good luck!

Richard Baxter, MD · Answer

Every case is different of course but your plastic surgeon has probably given you good advice about not just removing the implants. Breasts change as a result of having implants, so they don't just revert back to the original shape when they are removed, and it is difficult to reshape them sometimes. Our "rule of thumb" here is that a noticable change is around 100 cc, so the breasts should look smaller going from 350 to 250.

Scott C. Sattler, MD, FACS · Answer

No doubt about it- a step-down of 100 cc in a post-partum patient will result in breast sagginess. Your plastic surgeon is giving you good advice- maintain some breast volume with the smaller implant and deal with the resulting loose skin with a breast lift of some type. Whether a 'mini lift' is the right type of lift for you can only be assessed by the surgeon that has seen you. It sounds like you are on the right track and getting good advice.

Steven Wallach, MD · Answer

Whenever you go smaller after having implants for a while, you may require a lift.  This is hard to predict for all patients.

Peter A. Aldea, MD · Answer

Without a physical examination, much less a photograph, any answer can only be an estimate and generalization at best.
I agree with your Plastic surgeon and would suggest to you that you trust his judgment than rely on answers received either on this forum or the notoriously inaccurate on line chat rooms and forums.
When augmented breasts with 350cc implants look both big and sagging it tells me that there is much more breast skin envelope than breast fill. If your implants were to be removed, your breasts will become extremely saggy ("Rock in a Sock" look). A 250cc implant is a good compromise. It will provide some breast fill and it would need to be combined with a reduction of the breast skin envelope (IE a Breast Lift)/
Dr. P. Aldea

Darryl J. Blinski, MD · Answer

Yes, No , Maybe! Without photos, we cannot even try to guess if the question of size difference is a good one. Please forward photos for a specific answer, not my guess. Regards.

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