Breast implant revision. Possible to go bigger? I have 280cc anatomical implants put in a year ago. (photos)

Question

Hello, I had 280ccs anatomical implants put in a year ago and I feel like it's too small. I litteraly barley eat so my breasts looks bigger in comparison. I want to know if I'm a canidate to go larger (370-400ccs). I want it to look bigger from the side. Not in profile but larger "bugle" from the front out to the arms. My bwd is 12,5 cm

Ronald J. Edelson, MD · Answer

There is no problem going larger, you just need to decide whether it's worth the cost.  I think your current result is quite nice and would leave it alone.  Not worth shelling out more money.

Gerald Minniti, MD, FACS · Answer

Hello,
Judging from your preoperative appearance, it was appropriate to get the sized implants you did. A physical exam by a revision breast specialist should confirm whether increasing size is warranted and how much is obtainable; intra-operative sizers are unnecessary for determining this and increase the risk of capsular contracture.   Best of luck!

Urmen Desai, MD, MPH, FACS · Answer

Yes, based on your measurements, you can go with a bigger implant.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Farbod Esmailian, MD · Answer

Although it is always difficult to say without a proper exam, but in general I recommend going 100cc larger than the current implants to appreciate a noticeable difference.  So you are pretty much on with your assessment.  Anatomic implants do give a more natural look with comparison to round implants.  Round implants have more projection and can give more upper pole fullness.Dimensional planning will be key here and a thorough exam with evaluation of the implant measurements can help you achieve your goal.  Make certain you see a board certified plastic surgeon that has experience in breast revision.Hope that helps.

Daniel Barrett, MD · Answer

Dear nueboobz,determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. 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 its 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, everyone of them have 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.Daniel Barrett, MD, MHA, MS Certified, American Board of Plastic Surgery  Member, Am. Society of Plastic Surgery

Malcolm A. Lesavoy, MD, FACS · Answer

It looks like your Plastic Surgeon did a very nice job, and now one year later, your breast tissue has accommodated to the implants, and stretched a bit, and you could have larger implants.

Robert M. Kachenmeister, MD · Answer

Thank you for reaching out and sharing photos. As mentioned before, since you are about a year post op and still not happy, it definitely looks doable for you to replace with bigger implants. Whether you return to your surgeon or search for another, just make sure you do plenty of sizing to insure you love your results. Best of luck! Dr. Kachenmeister

Curtis Wong, MD · Answer

if accepting of the risks that come with it such as rippling and settling.  I hope your surgeon did not determine what size you could have as you could have gone larger at your initial procedure.  But there are surgeons who feel they know best for their patients and I don't adhere to that viewpoint.  It is the surgeon's job to educate patients and allow them to choose what is best for them... and to intervene if choosing ridiculous but still deferring the final decision to the patient or referring the patient to another surgeon if the choice conflicts with their conscience and need for control.

Tom J. Pousti, MD · Answer

Thank you for the question and pictures.   Although good advice would require in person evaluation, most patients are able to "go bigger"  during a  revisionary breast augmentation procedure. 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 physical examination and careful communication of your goals 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 "C or D cup” or "larger" 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 helps. Best wishes.

Jon A. Perlman, MD (retired) · Answer

Thank you for your important question.  Seeing that you allowed a year to pass for relaxation of your tissue, I think you can consider going to a larger implant.  My preference is for an Inspira mid profile plus round smooth silicone gel implant and I would be thinking in the mid 300 range for you.  I find that the best way to determine the optimal outcome and choice of implant is during the surgical procedure when test implants called sizers can be positioned with you asleep and upright position when we can best observe the actual outcome with each implant.  If you are currently 280 mL I would think 350 mL implant or perhaps lightly larger will work well for you.  Try to avoid going too large due to the increased risk of complications was a very large implant with naturally small breasts.  Enjoy the attached video for more helpful information and best wishes,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, CaliforniaIG: jonperlmanmd

Breast implant revision. Possible to go bigger? I have 280cc anatomical implants put in a year ago. (photos)

Answers (11)

More Breast Implant Revision Questions

WE SEND PRETTY
EMAILS

Answers (11)

More Breast Implant Revision Questions

Do I have uniboobs? (Photo)

Follow-up: update on breast. Is this necrosis? Will I need a skin graft to try to finally look normal? (Photos)

Is it possible for me to get 500cc anatomical tear drop implants for a fuller look? (Photos)

Is swelling normal after a capsulectomy and new implant?

What are the best implants for someone who is thin and consequently has very little breast tissue?

I want to downsize to 200cc to a more natural look. Do I need a lift? I'm Asian. Will my scar be really bad afterwards?

WE SEND PRETTY EMAILS

WE SEND PRETTY
EMAILS