Bigger Breast Implant Replacement After Ruptured Old Ones?

I am 5'7" weigh 135 lbs. I just had my Breast implant ruptured I am now doing silicone vs the saline. I had 380cc in my previous augmentation. My question is about my PS recommendation that I do 500cc, stating that with scar tissue that needed to be removed, I must go bigger than my old implants. I like my size now, but do not want to go through surgery then have them too small after cleaning out scar tissue. Suggestions?

Doctor Answers 11

Larger Implants with the Revision

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Yes, it is possible to #increase your implant size during a #revision. However, the #pocket will need adjustment and a lift may be necessary; to better #support the new implant. Additionally, a mesh for further support may be helpful depending on the #implant size and skin #elasticity. It's best that your procedures should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, lessen the chance of needing additional revision surgeries. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient reviews. Gathering all of this information will help you make a well-informed decision.

Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

Need To Look At All The Options

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At 5'7" and 135 lbs 500 cc implants will be large. I would hope that yourplastic surgeon has gone over all the options available to you. It has been my experience that you do not necessarily need to go with larger implants even when a complete capsulectomy is done with implant exchange. What I have usually seen is that there is some degree of capsular contracture present and by removing the ruptured implant and the capsule putting in the same size implants actually look larger because they are not as compresses.

Ultimately you and your surgeon should go over all the options and you need to get all your questions answered to your satisfaction.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 37 reviews

What size implants do you have now?

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Answering this question properly requires knowing your current implant size and if you are happy at your current size (i.e. how do you feel about your current appearance of the non-ruptured side). As mentioned by others, 500 cc would not be much of a change if you are in the 400 range already, and may be a good move especially if your breasts have gotten a bit "droopy" over time. If you are in the 300 cc range or smaller, t hen this would be a dramatic change and you may want to think twice before going so much bigger.

Brian S. Glatt, MD, FACS
Morristown Plastic Surgeon
5.0 out of 5 stars 59 reviews

Replace ruptured implants with larger ones

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You did not specifiy the size of your current implants.

If they are 450 cc then a new 500 cc implant is negligible.

If they are 250, then  a new 500cc implant is really a change.


Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

500 cc's is very large.

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Very large implants have more complications, look fake, and don't age well.

So in New York we hardly ever use 500 cc implants for breast augmentation.

I recommend using a disposable implant SIZER during surgery to find the best size before opening the permanent implants.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon

Yes, it is possible you need a larger implant

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If there has been a leakage and it was silicone before, it is likely that your surgeon may need to remove some of the breast tissue and scar, which will make you a little smaller. If it was a saline implant that ruptured, then the scar removal should be minimal. If you need to be larger, as per your surgeon, I am guessing that it is only a bit larger, not a substantial amount.

If you were happy with the old size, and your surgeon is not expecting to remove a lot of scar tissue then, you should stick with that size. If your surgeon is planning of removing some tissue, but you want to keep the overall size the same, then your implants need to be a bit larger.

Remember that this is the time for you to decide whether you want to be bigger, smaller, or just stay the same. Your surgeon can then guide which implant will suit this particular case. Good luck.

Sirish Maddali, MD
Portland Plastic Surgeon

With implant replacement choose what you like

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Whether considering your first augmentation, or replacement of breast implants that have worn the same rules apply: choose what you like. Most often leak or rupture will occur on one side so in the case of your saline implants if you were happy before, your surgeon has a model to match. You may of course have a smaller or a larger implant if you wish, the choice is yours to make.

We recommend that in the case of implant leak that both implants be replaced, unless the leak is within the first few years of augmentation. When switching from a saline to a silicone gel implant the implant will not always be the same size as the original saline though your surgeon should be able to match the look that you had prior.

The leaks we encounter today are most often from very old silicone gel implants 20 years or older. In most cases the implants have become misshaped, and firmly encapsulated (hard). The breasts will have a less than natural shape, though patients often accept this for many years. Capsule contracture with a worn implant causes the implant to round up and increases the projection. To approximate this shape or really the projection, a larger implant is needed with replacement, and as always it may be best to go back to pictures and other examples rather than rely on how the breast currently appears. This will give your surgeon the best guidance to get you to the result you wish.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

What do you want for your breast implants?

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In this, you know best.

The only way I could see this as being pertinent, is if he originally put in 450cc implants or 475cc (whatever), then overfilled them to 500cc's. In this case, a "larger" 500cc implant would be indicated. 

Ricardo L. Rodriguez, MD
Baltimore Plastic Surgeon
4.5 out of 5 stars 98 reviews

Choose your size

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You could have either larger or smaller -- it is your choice, dont let your PS pressure you. Silicone implants usually look a little smaller than the same size saline.

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

Pick what you like but it would not be a problem to put in a little bigger implant

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If your saline implants just leaked and you need to have them replaced then there is no reason for you to need to go any larger unless you want to. However if you have old silicone gel implants that have broken or leaked with a lot of scar tissue and or silicone granulomas you may wish to have a little bigger implants to replace the breast tissue and scar that will have to be removed.

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 17 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.