Saline exchange for silicone (Photo)

I'm 31, 123lbs, 5'5. I've had 420cc sailene implants for 11 years, in 2 weeks I will be exchanging them for silicone. I decided on 600cc HP, I'm currently a C cup and would like to be a nice D but NOT overly huge. Will the 600hp silicone be a good size or will they be overly huge?

Doctor Answers 6

Saline Exchange for Silicone

More women tend to choose silicone breast implants due to the natural feel and appearance. Silicone implants are now made of a cohesive gel which are anti-leak even when cut. Look and feel like natural breasts due to the cohesive silicone gel material. New generation silicone gel implants are far superior than those used in the past and have a proven track record of safety. Silicone implants have gone through more testing than any other medical device and are the preferred choice for over the muscle implant placement. To further ensure the safety, the FDA recommends women have periodic MRI testing to ensure their #silicone implants are free from any defects.

Some patients will experience better results to restore superior fullness if an #implant is used at the time of mastopexy; better known as #AugmentationMastopexy. Altogether, the surgery will create an elevated, more youthful breast contour. The nipple and areolae of the desired size and correct height may also be addressed. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring. A breast lift may also be recommended if exchanging your implants for a larger size. Also, increasing implant size requires adjusting the #pocket with a lift; to better #support the new implant. Additionally, a mesh for further #support may be helpful depending on the #implant size and skin #elasticity.

Your Plastic Surgeon needs to measure you and determine the best shape and size of any implants that are used. Any cosmetic #revision has risks of unhappy outcome or other complications. The right implant for the revision is contingent on shape of body and your desired outcome.  Your procedure should always be performed by a #Plastic Surgeon who is board-certified and has a great deal of experience specializing in #breast #augmentation and #revision #surgery.

Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews

Saline exchange for silicone

Thank you for the question.  Although it is not possible to provide you with definitive advice without an person evaluation, most patients are able to "go larger" at a second stage, once the breast tissues have expanded (after first-time breast augmentation).  Sometimes, during this revisionary surgery, adjustment of the breast implant capsules is also necessary to achieve the desired outcome.

You will find that online consultants will not be able to provide you with specific advice in regards to selection of specific breast implant size/profile.  

Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical. 

Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery (regarding breast implant size/profile selection) 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 are 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 "nice D but not overly huge”  etc 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.

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 ( after the use of temporary intraoperative sizers). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient.

I hope this, and the attached link (dedicated to revisionary breast augmentation surgery concerns), helps. Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

Breast Implant Sizing

Hello,You and your surgeon should be trying on sizers in the office with a tight, unpadded bra to see how an additional 200 cc looks. This takes the guess work out. Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 89 reviews

Saline to Silicone exchange 600cc

Thank you for your question. If you currently have 420cc saline, to exchange them for silicone and have the same look you would need to go up by 100cc. So going from 420cc to 600cc will probably make you slightly larger. Only you and your surgeon can determine if that is "too large", however any implant over about 500cc increases the long term complication rates significantly. Your surgeon should measure your base diameter(width of our breast) and determine which profile will fit best in the dimensions of your breasts. It sounds like you have a good plan, however make sure you are aware of the additional risks using an implant larger than 500cc.

Silicone to Saline

Thanks for your question and the photos. I'm a big believer that silicone is a superior implant and I think that you will really like the change. My personal opinion is that 600CC is VERY large and brings on increased risk of contracture, implant malposition and asymmetry. Everything has risks and benefits. I think you probably can go up in size, but 40% increase is a lot. Best of Luck!

M. Scott Haydon, MD
Austin Plastic Surgeon
4.8 out of 5 stars 90 reviews

Upsizing breast implants

I cannot say if they will be huge or overly huge. I can say that it usually takes a good 100 cc's of upsizing to even see anything.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 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.