Would 25 cc make a difference on the skin and cause more sagging?

Question

I need to have surgery soon to change my implants. I’ve already had a breast lift with 320 cc implants. This time, I’m planning to switch to 450 cc implants with a revision of the inframammary fold. Would it be wiser to choose 425 cc instead ? Does a 25 cc difference really have an impact on skin and can prevent sagginess?

Laura Roider, MD · Answer

Small volume changes (up to 40/50cc) will not have a significant impact on the skin or prevent sagging in the future. For reference 25cc is ~1.5tbsp of volume.

Daniel Barrett, MD · Answer

Dear C3434.

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

Wayne I. Yamahata, MD · Answer

A 25cc difference in volume is such a small amount that it's hard to imagine it would make a significant difference with your skin and sagging.

Donovan Rosas, MD · Answer

I typically discourage patients from struggling with small volume variations.

For comparison, a shot glass is approximately 44 ml. 25 ml is a subtle variance and unlikely to make or break a result. It typically takes at least 100 ml or more to create a detectable difference.

With regards to your specific question, you are unlikely be able to distinguish between 425 ml and 450 ml. If either is unsatisfactory, you would likely have needed to consider something much larger or smaller.

It is also important to remember that augmentation does not lift. No volume differential will address sagging. Greater volume will better fill an envelope and reduce redundancy but there is no effect on sagging.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

Mark Eberbach, MD · Answer

This volume difference is irrelevant. The base and projection is what matters.

Yet without seeing pictures there is no way to understand what you mean by saggy.

Would 25 cc make a difference on the skin and cause more sagging?

Answers (5)

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