Should I Choose Breast Implants to Accommodate Shrinkage over Time?

I was told that the size of the implant slightly shrinks over time due to the rib cage conforming and the implant flattening. I am getting my BA in 2 weeks. I can't decide whether I want 350 or 400cc. I am getting silicone cohesive gel, subpectoral, Inframammary incision. I am 5'7", 133 lbs. waist 27". My breasts measure 11-11.5" wide, 3.5" outward stretch. I like the look of the 350cc when I was sizing, it was recommended I go larger to accommodate for shrinkage. Advice Please!

Doctor Answers 6

Implant "Shrinkage Over Time"

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If you are talking about your breasts seeming smaller a few weeks after surgery, you should make an adjustment as follows:

  • Because the implant drapes differently under the muscle, it will look about 10% smaller than the implant looks when you put it in front of your breast in your bra.  
  • The muscle does flatten the implant somewhat and this creates a sense of the implant looking a bit smaller than it did when you tried it on for size.
  • Going up about 25-50cc is about right for the size you are choosing.
  • 3-Dimensional Imaging is another aid in choosing the right size.  The imaging does take into account the draping effect, so you see a good size representation in your 3-D image.  

If you are asking about possible changes that may occur over many years, I would not compensate for that at the time of your augmentation: it is too hard to predict how slowly aging may affect your breast size and appearance.

Denver Plastic Surgeon
4.7 out of 5 stars 46 reviews

I would go with your first choice the 350cc implant.

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I personally have not seen a notable change in my augmentation patients breast sizes over the years due to the mechanism you described or any other process short of implant rupture. In addition, you are agonizing over a 50cc difference which is relatively minor one way or the other. There will not be a dramatic difference in your breast size should you choose one or another. I would recommend selecting the size you seem to like best since I would not worry about a very questionable future spontaneous decrease in size. But then again selecting the larger implant, as advised by your surgeon, will as noted not result in that much of a difference. In other word, you cannot go too wrong with either implant.

David A. Ross, MD (retired)
Chicago Plastic Surgeon

Implant Sizeology

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Choosing the exact right size of an implant is, as Dr. Stephenson said, a very inexact science.  I don't blame you for agonizing over this question, but the good news is the 50 cc difference between a 350 and 400 won't make much difference in the long run.  Since more than 90% of my patients have candidly told me that if they had to do it all over again, they would have gone a little bigger, if I were you I would choose the larger size.


Should I Choose Breast Implants to Accommodate Shrinkage over Time

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AS much as this sounds reasonable, I  have patients that report increase in natural breast tissue over time associated with hormonal changes, pregnancy, weight gain and menopause.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Implant sizing is an inexact science

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Not real sure about the rib cage "thing" .  The best thing to due is to follow your surgeon's advice after you all have had a long discussion about what is possible to to achieve the look you want.  Whether it is a 350 or 400 is not going to make much of a difference.  Trust that your surgeon understands the look you are trying to achieve.

Dr. ES

Breast implants

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If you liked the look of the 350, then I would probabaly go with that one. I couldn't tell you for sure without evaluating you in person.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 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.