Breast Augmentation Revision Options After Deflation

I had 550 cc moderate profile saline implants done in 2005 thru the armpit. Last week I had deflation in one breast. I've been to four consultations and learned I have capsulation and that the implants never made it into the pocket, I am a 36 D and would like to be a 36 DD. I am 5'8.5 and 150 lbs. At the consultations I've been told to go up to 700, 750, 775 and 800 cc's to achieve the size I want, I have also had different opinions on going high or moderate. What will give me the desired look?

Doctor Answers 22

Breast implant deflation

Thank you for your question.  The volumes you were given sound accurate. I would estimate that anywhere from 650- 750 ccs would allow you to achieve your desired size.  However, when there is implant deflation, scar tissue usually forms around it which will need to be removed.  If the scar tissue is not removed, the breast will not fill out due to constriction.  Also the pockets will need to be enlarged to accommodate the larger implant usually in the superior and medial aspect of the breast. Depending on your chest dimensions, a moderate plus or high profile implant would be best.

Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 191 reviews

Revision choices require examination and...



When considering revision, choices require good judgment. You need to have a good "face to face" discussion with your surgeon and a good exam to determine your best alternatives.


Issues such as tissue elasticity and your chest diameter will be important in predicting your best implant geometry. Guessing over the internet is not going to be much help to you here.


Best Regards

John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 27 reviews

Revisionary Breast Surgery

Clear communication with your plastic surgeon is important in achieving the desired goals of the patient.  I like to communicate with patients with “goal” pictures.  During surgery, I use temporary sizers to determine the size/profile that will give the patient the look she is looking for. Trying to predict the size of the implant preoperatively is not ideal.  I think it is too much responsibility for the patient to choose the size of the implant.  Ideally, the surgeon would make that determination once he/she is in the operating room with sizers in and examining the patient in the upright and supine position.  There are many variables that come into play when choosing the correct implant size (how much breast tissue the patient currently has, the shape of the chest wall (concave vs. convex), etc..  Some places have you put bags of rice or implants in your bra – that is normally not very accurate.  I don't recommend going through the armpit, I prefer an peri-areolar incision for the best access to the area.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,498 reviews

Breast implant revision

Your deflation is an opportunity in disguise because you can make some changes now.  First, you need a new incision, not the armpit anymore.  Second, capsules if thick need to be removed.  You might need submuscular conversion if you are above the muscle (most armpits are below the muscle though).  As for size, you should go for the "look" you want (not the cup size) by trying on sizers on your deflated side to see what implant will get closest to what you want.  

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Trust your instincts

You have had several consultations which is a good start. Hopefully you have a good feeling about at least one of the surgeons. Hopefully you have a few good references for the one you like. Details of implant volume and style are secondary to the skill and judgement of your chosen surgeon. Likely a moderate plus profile would be best as you are looking for more impact and the volume will likely have to be at least 650cc or more to achieve a bigger cup size.

David J. Levens, MD
Coral Springs Plastic Surgeon
5.0 out of 5 stars 76 reviews

Breast Implant Revision and Going Bigger

First of all because the encapsulation, any revision will need an incision on the breast. It is difficult to give you an exact answer regarding implant size without actually examining you, but when you get into the 700cc+ sizes you are inviting some potential problems down the line. The implant needs to respect your breast dimensions, especially the breast width. Also because you will need a capsulectomy on the one side, this may leave your tissues thinner and make it more difficult to support a very large implant. Hope that helps and good luck!

Babak Dadvand, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 46 reviews

Breast Implant deflation and Revision

Breast augmentation through the armpit is a great way to hide scars from breast augmentation. However, in the event of deflation or revision, usually, a different approach is needed. Addtionally, I would not recommend a large implant in the range of 700cc. Large implant will give you more problems in the future. The best way to solve your problem of capsular contracture is to see a board certified Plastic surgeon experienced in doing revision breast surgery. There are now many techniques used to treat this condition.

Good Luck. Dr Okoro

Stanley Okoro, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 160 reviews

How to treat a deflated implant and capsular contracture

I would not recommend using breast implants in the 700-800cc range.  This will lead to premature sagging and atrophy (thinning) of the soft tissue of the breast.  I would recommend doing a capsulectomy (likely on both sides) which will be best performed through either a periareolar or inframammary incision-not through the armpit.

You may consider converting to silicone implants also which have a lower incidence of rupture.

Although you are tall and have a frame that may be able to accommodate larger implants, in the long run, patients with larger implants (700-800cc) will have more complications.

Best wishes,

Dr. Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 376 reviews

Breast augmentation revision

Implant deflation is a known complication of saline implants, and revision usually requires a different incision than the initial axillary one that was used to insert your implants - either an inframammary or a periareolar one. Determining the best implant size for you requires a complete physical examination, but very large implants (such as the 700+cc ones you are contemplating) are fraught with complications and long term negative effects on the tissues.

Olivia Hutchinson, MD
New York Plastic Surgeon
5.0 out of 5 stars 8 reviews

Large breast implants will be faster to sag

Based on your photos, your deflated right breast still has a respectable amount of breast tissue and is not ptotic.  The left breast implant is positioned too high and the capsule is creating that unnatural bulge just below your collar bone.  Revision can work with a large implant, but I would also consider use of a biologic implant such as Strattice or Alloderm to help counter the inevitable sagging with gravity in the future.  The choice of moderate or high profile will depend on your base measurements in relation to desired projection.  I suggest you talk to your surgeon about anatomic balance more than a specific size.

Randy Wong, MD
Honolulu Plastic Surgeon
4.8 out of 5 stars 36 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.