How Much Bigger is 600cc Silicone Than 425cc Saline?

Question

Hi, I am 5'5 120lbs, 2 kids, breasted one, no sagging or stretch marks. I rencently had an augmentation 3/29/11 425/435cc saline HP. I am planning on redoing mine in Sept of this year going to 600-650cc Silicone HP. I am experiencing rippling(within 6 months after) one has not dropped all the way either. I was told switching from saline to silicone should help reduce th rippling due to very little breast tissue. I am currently a 32D(push up bra) what size should I be after my surgery?

Antoine A. Hallak, MD, FACS · Answer

Hi, switching from saline to silicone can help reduce the rippling but the corrrect size to pick has to be discussed with your surgeon. going from 425 to 650 is a big jump and i suggest you discuss that with him/her and look at several before and after pictures.
	cup size prediction based on implant size is not very scientific or reliable.

C. Bob Basu, MD, MPH, FACS · Answer

Based on your question, it sounds like you are experiencing rippling following saline breast augmentation.   This can be due to your tissue being thin.  hence there is very little tissue coverage over your saline implant.  This can manifest in ripping.   if this is the case, then I would likely recommend 1) a transition to a silicone gel implant and 2) a transition from the above the muscle to the under the muscle/dual plane position.   A silicone gel implant will help with the rippling.  In addition, the upper pole muscle coverage will help camouflage your implant.   Now, in terms of size, my answer would depend on your goals.  Are you happy with your size or would you like to go bigger.  Based on your answer, and your chest wall dimensions, I could make some recommendations.  But, as my colleagues have suggstion, a physical exam is needed to make any recommendations.  Hope this helps.

	Dr. Basu

	Houston, TX

Steven Wallach, MD · Answer

With that size increase you may go up about a cup size.  But it is hard to say for sure because all bras are built differently.

Tom J. Pousti, MD · Answer

Unfortunately,  no plastic surgeon is able to accurately predict what cup size you will end up wearing after breast augmentation with a certain size implant. As you know, you may end up wearing different bra cup sizes depending on who makes the bra.

	I would suggest that you communicate your goals with your plastic surgeon ( I prefer the use of goal pictures)  and ask him/her to do his/her best to achieve the results you're looking for.  You may want to leave it up to him/her to use a breast implant that he/she feels will do the job based on intraoperative evaluation.

	I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.  I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.

	Again, in my opinion, it is best to set your goals and  level of satisfaction with the results of surgery,  on achieving a certain look/proportionality,  not a specific cup size.

	I hope this helps.

How Much Bigger is 600cc Silicone Than 425cc Saline?

Answers (4)

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