5'3", 113 lbs, 40, athletic and a small/petite frame. Do the pros outweigh the cons for implant exchange from 385 cc to 505 cc?

Question

I had my first BA transaxillary UTM 1 yr ago w Sientra 385 MP+ and love my results but feel they are too small. Recovered well and I’m ok with anesthesia. I'm 5'3" 113 lbs & 40 years old, athletic and a small/petite frame. Before my initial BA I breastfed 2 children. My preop size was probably 32 A so not too much breast tissue. Scheduled to upgrade to 505 cc Sientra MP+ with the same surgeon but am getting cold feet. My surgeon & family/friends say I''m proportionate now and they don't understand why I'm doing the upgrade. Personally I wish I went bigger initially. I would like some other professional opinions if changing implant size when I have no issues has more risks (aka sore back/neck due to implant size, bottoming out, need for a lift in the future) than positives. Any feedback would be greatly appreciated.

Daniel Barrett, MD · Answer

Dear amani33,

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

Darryl J. Blinski, MD · Answer

Your question is quite intriguing. In the fact you’re undecided. If you should follow your own thoughts or your surgeons and family thoughts. The issue is you did not post any photos to give a more definitive decision. Therefore, I would recommend you have a sit down with your surgeon or his medical assistant have a detailed in person conversation. Any surgical procedure has risk just so you’re aware, the minimal good and bad things can always happen. Good luck and I hope you come to a decision that will make you happy.

Mats Hagstrom, MD (license on probation) · Answer

To make an assessment regarding the outcome of any plastic surgery procedure, we need to see proper before and after pictures.
If you don’t have before, and after pictures, then ask your surgeon to forward the pictures they took.
Anytime, excessively large implants are used the chance of undesirable side effects, complications and need for revision surgery will always go up.
 Based on the numbers, you’ve included 500 mL sounds excessive.
Best,
Mats Hagstrom MD

5'3", 113 lbs, 40, athletic and a small/petite frame. Do the pros outweigh the cons for implant exchange from 385 cc to 505 cc?

Answers (3)