I Have a 335cc Cohesive Gel Implant, and I Want to Go Bigger.

I have a 335cc cohesive gel implant. I find that the gel size are smaller than the saline size,is that true?. All my friends had saline implant put in, but their size are only 275cc or 300cc; but they are much bigger than mind. Now I want a revision but dont know what size to choose. Would another 100cc make any different? how big should I go if I want one cup bigger? Thank you for taking time to answer my question.

Doctor Answers 9

Breast implant sizing

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 press 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.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Saline vs Silicone

First there are so many variables to consider when comparing yourself vs your friends. What size did they start with? What size chest or rib cage, etc, etc. That said, here's my rule of thumb: What ever size you try on in the office and like you must increase by 10-20% for the actual size you place at surgery. You lose approximately 20% of apparent size because they are in you not on you anymore. Finally, saline implants give about 20% more projection than saline. So when I see a patient going from saline to silicone I tell them if they want to stay the same size we have to go 20% larger on a silicone to equal the same volume in saline. Example - patient has 300cc implants inflated to 360. To switch to silicone she needs (same style) 430 silicone (or the closest size to that that is available).

Clayton L. Moliver, MD
Houston Plastic Surgeon
4.5 out of 5 stars 33 reviews

Revision breast augmentation

It would be helpful to see before/after pictures (or at least after pictures) to answer you. But in general, there may be a difference in how much projection of enlargement you get with a silicone implant and a saline implant of the same size. I usually have to use a larger silicone implant to achieve the same volume as a saline implant of any given numerical fill volume. For example, if the patient looks good with 350cc saline, she might need a 400cc-425cc gel implant to look the same way.

In general, yes, going larger usually requires at least 50-75 cc added volume to make a substantial (cup size) difference. Have a consultation and see what your options are.

Tim Sayed, MD, MBA, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 17 reviews

I Have a 335cc Cohesive Gel Implant, and I Want to Go Bigger

Very hard to advise without before and after photos posted, my guess is you need at least 150 cc+. Discuss this with your surgeon. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 174 reviews

Want to go bigger with a gel implant

The volume of the implant is the same for silicone and for saline.  It is very difficult to compare your size with your friend's sizes since your body characteristics might be very different.  Breast size, muscle development, rib cage size and skin elasticity will vary with each individual and will therefore make the implants appear different.  Implants also vary as it rates to the width and the projection of the implant so they will look different on each patient.  You should talk to your doctor about options that relate to your body type.  In general, 100cc would give you a noticeable size change.

Elizabeth S. Harris, MD
San Antonio Plastic Surgeon
4.9 out of 5 stars 20 reviews

Going Bigger

Usually 100 ccs will take you a cupsize larger. This is a rough estimate and depends on the the body size.   It also depends on the profile.  A high profile has more projection and makes it appear larger.The silicone is a more natural feeling implant.

Miguel Delgado, MD
San Francisco Plastic Surgeon
4.8 out of 5 stars 76 reviews

Replace with larger implants

Saline implants and silicone gel implants of the same size are of course the same size, at least in terms of their volume.  There are different implant profiles in saline and in gel implants, and this affects how wide the implants are and how projecting they are...that is, a high profile implant and a moderate profile implant of gel of a given size are the same volume, but one is narrower and more projecting, while the other is wider and less projecting.  Also, saline implants are oftentimes slightly firmer and more projecting and "rounder" looking than an equivalent gel implant. Gel implants tend to look more "natural", but some patients like a less natural appearance and want more upper pole fullness, so they would need to go to a larger implant to achieve that.  It is difficult to compare your augmented breasts with your friends' results...factors of breast tissue thickness, amount of skin to drape over the implant, ribcage shape etc. all affect the appearance and perceived size of the breast, and chest width affects cup size measurements. If your friend has smaller implants and her breasts are larger, she must have had more of her own tissue to which the volume of her implants has been added.  It sounds like an increase of at least 100cc may be needed to give you the size increase you are looking for.  You can always show your surgeon photos of breasts that you like so they know what your goals are.  If I have a patient who is looking for more upper fullness than is completely "natural", it helps for me to know that is their goal so that I can aim in that direction in choosing between implants of different sizes.

Robert M. Grenley, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 87 reviews

Saline implants may feel bigger than silicone. Implant pocket adjustment may help.

Many factors determine how large the breasts look and feel after augmentation:

  • the size and profile of the implant;
  • saline vs. silicone;
  • placement above vs. below the pectoralis muscle;
  • how much breast tissue was initially present and its quality/firmness;
  • breast skin thickness, elasticity, and droop;
  • body fat percentage
  • history of pregnancy and breast feeding;
  • body weight, height, and proportions.

In reference to your questions:

  1. Saline implants may feel larger because they tend to have provide more fullness to the upper pole of the breast. Some patients like this look and feel; others prefer the softer, flatter upper breast that silicone implants tend to provide. Often a slightly larger silicone implant is needed to match the fullness of a saline implant.
  2. If you decide to increase the size of your implants, a 100cc difference is often not enough of an increase to make a patient who wants larger implants happy. However, I think it is critical to evaluate the breast implant pocket and positioning. Many implants that feel too small have settled too low on the chest and too far to the sides. Adjusting the pockets, the implant position, may help tremendously in such cases.
  3. Of course these are general observations. The nuances of your case depend on your goals and physical findings.
  4. Don't rush into revision surgery until you have discussed your options thoroughly with a surgeon whom you trust.

Thanks for your question.

Steven Goldman, MD
Cleveland Plastic Surgeon
5.0 out of 5 stars 149 reviews

I Had a Breast Augmentation, and I Want to Go Bigger.

There are many factors in deciding which is the ideal implant to achieve a desired result. All types of  implants will augment your breast the same. The cc's indicate the volume and size, which is standard for saline, silicone, or cohesive gel. You should wait at least 6 months from your original surgery to exchange the implants in order to decrease complications. An implant 150-200cc's larger will increase your breast one cup size. 

Frank Agullo, MD
El Paso Plastic Surgeon
4.9 out of 5 stars 141 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.