Not happy, with 245cc motiva demi - should I replace with 320 or 340?

Question

Hi, I did an breast augmentation with motiva 245cc demi. However, I am not happy. I was a 70A before, I am a 70C now. I weigh 53kg and I am 164cm tall. I was flat before with a lot of and tight breast tissue according to the doctor. I am now thinking of doing a revision and I am in beteween choosing motiva 320cc demi or motiva 340cc demi. My goal is to be able to wear the same bralettes (small) as before and have the same shirt size as before (xs/s) but having it more filled. Will i be able to achieve it with 320 or do I need 340

Semih Yildiz, MD, FEPOBRAS · Answer

A 20 cc difference between 320 cc and 340 cc is usually a very subtle change, so the choice should not be based on volume alone. Implant width, profile, tissue tightness, pocket position, and how much upper-pole fullness you want will matter more than that small number difference. Moving from 245 cc into the low 300s may give more fill, but it may also change how small bralettes and XS/S tops fit, so that cannot be promised from measurements alone.
If your augmentation was recent, give the implants time to settle before committing to a revision. If you are fully healed and still feel underfilled, your surgeon should compare the 320 and 340 implants against your breast base width, tissue thickness, skin stretch, and current pocket. On a smaller frame with tight tissues, a larger implant can sometimes create a rounder look, more tissue stretch, rippling, or pocket issues. I would use sizers or 3D imaging as a guide, but the safest choice is the implant whose dimensions fit your anatomy rather than simply choosing the larger number.

Daniel Barrett, MD · Answer

Dear hazel.,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Chet Mays, MD · Answer

Thank you for your inquiry. We would love to sit down with you and talk about your concerns and goals. A bigger implant will fill out the breast pocket and add more fullness/volume.  You can go for a consultation and try on both the size implants to give you a better idea of what the implant will look like after surgery.  Schedule a consultation with a Board Certified Surgeon.

Luis A. Mejia, MD · Answer

In my opinion, both 320 cc and 340 cc Motiva demi implants will give you more volume than 245 cc, but 320 cc is more likely to keep you in a natural range that fits your goal of wearing bralettes (small) and keeping your xs/s shirt size. The difference between 320 cc and 340 cc is relatively small, but it can be noticeable on a petite frame.

Since your priority is fuller without looking “too large”, 320 cc tends to be more predictable for that sweet spot between enhanced and natural. A careful in-person assessment of your chest width, tissue characteristics, and pocket will help confirm which size best matches your goals.

Whenever you’re ready:
Let’s make it better.

Warmly,
Dr. Luis Mejía, MD
Board-Certified Plastic Surgeon
CECILIP – Dominican Republic

Donovan Rosas, MD · Answer

Choosing an implant size/style is an important decision which is best made in concert with your surgeon. Ultimately, options are based on a number of factors including:
-Chest dimensions: This point is crucial as the width of your breasts defines the available "real estate" on which the foundation of your augmentation is built. This "foot print" is the absolute limit with which you are dealing.  Too "large" is not so much the risk as too "wide." You cannot build a 3 acre mansion on a half acre plot. An implant which is too wide (exceeding the available space on your chest) will generally over hang laterally making it more noticeable and occasionally contributing to discomfort and nerve symptoms (numbness or tingling). This will also contribute to a more unnatural look.
-Tissue quality: This relates to size in the sense that the implant will be suspended by your tissue. Too large an implant may place took large a stress on these suspending tissues leading to healing problems in the short term and bottoming out in the long term.
-Patient desire (what is the look you are hoping to achieve?)
My role as a surgeon is to manage expectations and guide you towards a prudent choice which can satisfy these reasonable goals. Often times, a surgeon can guide a patient toward a size/cc range and patients will make determinations on implant style/profile. Patient seeking more or less projection, or seeking a more pronounced or subtle upper pole volume increase can be guided toward an implant which will help them best achieve their goals. Additionally, technique variations (sub muscular vs. sub glandular) can also aid in obtaining the look you desire.  
There are a number of tools available to help guide patient/surgeon decision making including sizers, 3D imaging and goal photos. Each modality can help better communicate your goals to your surgeon and vice versa.
With regards to your specific question, I recommend a 100 cc change if you are seeking a visible upsize. It is important to realize that small differentials are unlikely to make or break a result. A shot glass is slightly less than 50 ml. 320 vs. 340 are likely to be indistinguishable.
Ultimately, it is important to not marry oneself to a particular "cc" as oppose to a particular "look." Communication is key as you and your surgeon create your custom surgical plan. 
As always, discuss your concerns with a board certified plastic surgeon.

Camille Cash, MD · Answer

Without examining you it's difficult to give a specific recommendation.  However if you were unhappy with the 245cc implant it may be best to go with the 340cc.  The difference between the two implants you're considering of 20cc is just over a tablespoon of volume and won't be noteable once placed inside the body.

Not happy, with 245cc motiva demi - should I replace with 320 or 340?

Answers (6)

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