500 Cc's Implants Already a 36dd is 500 Too Big?

Switching to larger implants may give you more upper pole fullness but only for a short period of time.  They will gradually drop just like your current ones did and you will end up in the same situation you have now.  To fully answer your question please send photos.

Implants will only add to your volume.  If you are already a DD cup then I doubt you really want to do that, especially with such large implants.  Some of my happiest patients are the ones who have breast reductions to lose some of that weight that is pulling through their neck and shoulders.  It sounds like you simply might need a revision of your breast lift procedure in order to redistribute the volume that you already have rather than simply adding to it.

    In general, I typically place smaller implants if the only goal is upper pole fullness (maybe 275 cc to 325 cc moderate profile).  This tends to fill the area well without creating too much projection.  Also, I am trying to protect my patients from back, neck, and shoulder problems with such large breasts.  However, I do create a very tight skin envelope, perhaps tighter than many, with the breast lift.  You would have to be examined or pictures would have to be viewed to give a better answer.  Kenneth Hughes, MD Los Angeles, CA

It sounds like you have enough tissue already, but it is in the wrong place!  I have found this to be the typical problem with the various types of "anchor" lifts.  All those scars and everything is as the bottom (and often the sides) with no upper fullness.  Often looks like an exaggerated tear drop!  The term "perky" has to be deleted from your vocabulary.  This is why I gave up on "anchor" lifts in the early 90's, even trying an earlier technique from S. America in the late 80's.  Internal shaping and suspension with the vertical technique has allowed this change because the technique doesn't rely on a segment of tissue bringing in enough circulation to keep the nipple alive. I have re-done many women over the years that had "anchors" that were fine with their size but not the shape, as well as those that didn't like the size, either.  I have found it safe.....and effective....to do the vertical technique with reshaping the tissue to get the upper fullness.  No nipples have been lost in this reshaping.  It has been interesting to notice that these re-do's usually do not require moving the nipple further up.  But this reshaping of the tissues can make you look like you had a lift, even though the nipple hasn't moved!If you don't like your present size at DD when you are supported by a bra, then an implant may be necessary.....besides all the other techniques mentioned.  Just putting an implant in will just give you a bigger version of what you have.

Photographs would be very helpful here. I generally use much smaller volumes for breast enhancement with a lift

I have never understood the desire on the part of patients or physicians (especially physicians) to create unnaturally large breasts. I see 'before and after' photos at plastic surgery meetings and I almost always find myself asking the question: What's the `big' idea?

I view breast augmentation as more than a breast enhancement surgery. It is a total body contouring surgery, and the breast profile that one creates with implants should match a patient's overall figure. It should appear completely plausible that the breasts have not been surgically enhanced. I want for my patient's appearance to make others think "Wow - what a great figure", not "I wonder who her plastic surgeon is".

Over and over I hear patients remark, after reviewing some of our `before and after' photos, that they had no idea that a breast augmentation could look so natural. It can, and in my opinion it should. Having practiced plastic surgery in the 'breast augmentation capital of the world' (Los Angeles), and having performed hundreds of breast augmentations in North Carolina for patients who are seeking a breast enhancement that looks like it actually is a natural part of their body, I have developed some fairly strong opinions about this operation.

When considering breast augmentation surgery, I believe that the most important question for a prospective patient to ask themselves is this: Am I seeking a natural-appearing result? If the answer is yes, then seek out a surgeon who has the same aesthetic sensibility that you have (and appropriate training and experience). And insist on seeing `before and after' photos. A lot of them.

Without at least the aid of pictures it is difficult to give advice. However it sounds as though you would benefit from a revision of your mastopexy (breast lift). I would caution you that this size implant will more than likely give you an approximately 2 cup size increase.

My recommendation would be to return to your plastic surgeon to discuss your concerns with them. If afterwards you still do not feel comfortable with the plan offered, then consider getting a second opinion, preferably in person. Good luck

Without an exam it is difficult to comment. You may need a revision of your lift as well to give upper p[ole fullness. The implant will definitely add volume.

They sound pretty big--perhaps an increase of two cup sizes. Without photos it is hard to comment. Consider posting some and asking your question again. The best way for getting a useful second opinion is in person in a surgeons office. All the best. 

Thank you for the question.


As you can imagine, despite your good description of body type and goals, it is not possible to give you precise  advice online.
The best online advice I can give to ladies who are considering breast augmentation surgery is:



1. Concentrate on choosing your plastic surgeon carefully.  Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you're looking for. Ask to see lots of examples of his/her work.




2. Have a full discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining  breast implant size/type/profile will most likely help achieve your goals. 
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 “upper pole fullness” etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup  size may also be inaccurate.




3.  Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.


I hope this (and the attached link) help.