After MM and BA Cc Recommendation I Still Want Bigger. Who' Responsible for Cost?

I just had a MM March 9th and couldn't be happier. Love my PS and his office. My question is I had an BA exchange from old saline implants sized 350cc from 1995. I switched to silicone and asked for a full d or small dd...PS gave me 445 cc silicone. He seemed reluctant to go too much larger. To me, granted I am 10,days post op but doesn't seem like I swelled at all in the breast area, I feel I am just about the same size as before which was a full c. Revision possible? And who pays, PS or me?

Doctor Answers 7

Who is responsible for cost of upsizing breast implants

First of all, I'm happy to hear that you are overall very satisfied with your results and your experience with your Plastic Surgeon.  It is impossible to guarantee that a specific cup size will result from your breast augmentation.  A pre-operative discussion of cup size goals is definitely helpful to understand our patients' specific goals and to try to achieve the volume that you desire, but cup sizes are highly variable amongst different bra manufacturers and are not a predictable end point of breast augmentation. 


From your description, your Plastic Surgeon did listen and respond to your goals by increasing your implant volume by 95cc.  At times, it is not safe or advisable to increase volume too dramatically, and your Plastic Surgeon may have been concerned about factors such as blood flow, tissue tension, wound healing, or future breast sagging when he/she did not feel comfortable increasing your size more than he/she did.  Your Plastic Surgeon is very interested in your satisfaction, and I recommend that you talk to him/her about your results.  It may be that it would not be advisable to consider any larger of a breast implant size.  Different Plastic Surgeons have different policies regarding revisional surgery, but most would consider the cost of upsizing breast implants to be the responsibility of the patient.  It is worthwhile asking!

Portland Plastic Surgeon
5.0 out of 5 stars 2 reviews

If you get a good result from a breast augmentation, don't risk it on another operation to be a little bigger.

It is my practice not to charge the patient an additional professional fee for a revision.  However, your surgeon chose a much larger implant, so you cannot be smaller than before.  If you end up with aesthetically pleasing breasts, even if you might want to be a bit larger, don't risk the results by subjecting yourself to another operation.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.8 out of 5 stars 36 reviews

Too Small after Revisionary Breast Augmentation Surgery?

Thank you for the question.

Unfortunately, no plastic surgeon can guarantee a specific cup size after breast augmentation or revisionary press augmentation surgery. Your plastic surgeon may have had specific reasons why he was “reluctant to go to much larger”. Sometimes it is not possible to go larger without significant risks.

I would agree with you that it is too early to evaluate the end results of surgery. I would give yourself at least 3 to 6 months before making this evaluation. If at that time, you still feel that you are too small discuss your concerns with your plastic surgeon in a calm fashion.

It may or may not be possible to revise the breasts to a larger size.  If you do decide to undergo further surgery,  be careful about communicating goals in relation to a specific cup size.  I think the use of gold pictures are more helpful.

There is no “standard” policy among plastic surgeons in regards to the financial arrangements;  again, you will have to discuss this with your own plastic surgeon if/when the time is right.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Still want bigger after augmentation

A revision is certainly an option if you wish to have a fuller breast implant and a fuller cup size. The implant number is a guess at best, and even a cup size can be deceiving. Photos may do a better job for the right 'look'. I hope you showed your surgeon your ideal DD-cup.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Post Op, I Want Bigger Breast Implants Than I Agreed To - Who Pays?

Congratulations on your Mommy Makeover.  I am sure the results will make a positive change in your life.  Ten days after surgery, everyone goes through a depression sometime between 5 days and 2 weeks post-operatively.  The depression has to do with getting the anesthetics out of your system, first taking and stopping taking narcotics, the swelling, and also and most importantly, your expectations, your fears and the difference between the reality that other people see and the reality that you see in the mirror.

At this point, remind yourself that you trusted this plastic surgeon with your looks and your life, and you are both alive and happy.  Trust his or her judgement at this time and allow yourself at least 3 months, and probably 6, to allow things to settle, swelling to subside, and the discomfort post-operatively to clear itself.  You will be surprised how things change, so give yourself a break. 

With reference to who pays for a redo breast augmentation because dissatisfaction with size, it depends on the surgeon's policy, one that should have been explained to you completely and that you agreed to.  Every surgeon has his or her own policy, and if you are not told about it upfront, you should ask and it would not be inappropriate to get it in writing. 

That being said, in my practice I tell each and every patient that if anything goes wrong in the first year after a breast augmentation, that I am responsible for any redos except for anesthesia fees.  The one exception is size because it is very difficult to get inside each patient's head and be sure the size they choose and sign for is actually the size they want.  However, once you are my patient, I have a greater responsibility to you than someone I have never seen before.  Therefore, I would take partial responsibility, to include the cost of the new implants and, possibly, some reduction in OR costs, but not before allowing the swelling to go down (about 6 months).  This would be on a case by case basis in my practice, but I recommend you talk to your surgeon and see what his or her policy is.

After Breast Augmentation - Still Want to be Bigger - Who Pays?

I'm glad that you are in general happy and "love your plastic surgeon" - i.e. you have a great patient-physician relationship.It sounds like you have a great plastic surgeon. He might discount a subsequent procedure to make your breast's larger but that would be as a favor as ultimately you would be responsible for these costs.Here is the explanation -


Your Plastic Surgeon did listen to your wishes and  responded appropriately  by increasing your implant volume by 95cc or about 27% larger implants.Cup size is anything but an exact science. Did you give him a photo of the relative size you wanted?  Please note that it is impossible to guarantee that a specific cup size will result from any patient's breast augmentation as to some degree this is an arbitrary measurement differing from manufacturer, bra type or even which hook you fasten..  Cup sizes are highly variable and are not a predictable end point of breast augmentation.Often during surgery the surgeon is faced with quality issues vs quantity. In my mind quality should always win as a beautifully shaped breast is more important than a large but unattractive one.

I also want to comment about the fact that the majority of Plastic Surgeons only guarantee their best surgical effort and experience to give you the best results they are capable of but they do NOT Guarantee a final result. Guarantees that you will be happy with the results, and that there will not be any problems afterwards is being unrealistic.
Plastic Surgery is an inexact science and art form. For example it is not like carpentry where you can measure and make a piece of furniture over and over exactly the same both immediately after you finish and in the future. All surgery has risks which the surgeon may not be able to alter. You as a patient need to understand, and it is the plastic surgeon's responsibility to make you aware of the risks associated with this procedure. This is called "informed consent". Most plastic surgeons (all surgeons for that matter) would agree that that it is important for the patient to understand that what they are paying for is  the best possible effort using all of their skill and experience to achieve your goals. There are no direct or implied guarantee of results as too many variables exist between patients (such as loss of elasticity, underlying muscle imbalance, sun damage, prior trauma, smoker, anatomic variation, etc, etc).


Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 157 reviews


You and the surgeon discussed size before. You went larger, it is not the plastic surgeons fault you may want bigger.

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 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.