Breast Implant Exchange Expectations Not Met... Now What?

I just had a breast implant exchange. One had deflated. I my agreement it said "increase 1 cup size". I learned my previous implant was 330cc and the new ones are 395cc. I had a lift also done. They appear wider but not necessarily larger (looking down at them). The 65cc difference and removing of the excess skin, they appear the same size or I actually thought they were smaller originally! What do I do now? I wanted to avoid confrontation so I told the nurse to let him know.

Doctor Answers 15

Unhappy with breast implant size

There can be no guarantee of what constitutes a one cup size change. I would never make such an aggreement with a patient, as cup size from manufacturer to another varies too much.  Also, in patients who need a lift, sometimes there is a limit to how much larger an implant can fit without placing too much strain on the incisions, which could at best lead to wider, worse scars and at worst to the incisions coming apart.  It is always difficult in revision cases (where simply having patients try different sized implants in a stretchy bra pre-op is no longer an option) to make sure that the surgeon and the patient communicate with each other what is to be accomplished (or attempted) and the limitations that may exist.  It does not sound like your surgeon did anything wrong, except for maybe making an agreement to increase you one cup size, if in fact they did that, since that makes it sound like a guarantee that you counted on.  Obviously you need to discuss this with your surgeon.  New larger implants may be able to be placed in you, depending on your tissues, and some costs should be expected, including implant fees and OR fees, even if the surgeon waives any fees for his services.

Seattle Plastic Surgeon
4.9 out of 5 stars 87 reviews

Breast Implant Exchange Expectations Not Met

Sorry for your unhappiness. Your surgeon was foolish to enter into an agreement based on cup size as this is bound to lead to misunderstandings. If you can remain calm and clear, then you should communicate your concerns directly with your surgeon. Your surgeon will then be able to identify ways to ensure your happiness.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 39 reviews

Breast Implant Revisionary Results?

Thank you for the question.

I'm sorry to hear about your dissatisfaction after breast revisionary surgery;  you should wait on making a final judgment about the end results of surgery ( approximately 6 months after surgery). At that point,  if you have concerns you should discuss these in a calm/nonaccusatory fashion with your plastic surgeon.

I'm sure you're aware that no plastic surgeon can promise specific cup size or symmetry with breast  surgery.

Hopefully, with clear communication you will ultimately be satisfied with the results of your breast surgery.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

Breast Implant Exchange Expectations Not Met... Now What?

Your situation highlights the critical importance of good communication between patient and surgeon and touches upon realistic expectations.

As most women out there know well, there is NO standard bra cup size; In other words, a C is not a C in all bra manufacturers. With a rampant lack of standards, how can anyone ethically promise you a certain cup size. While most of us guess that a cup size is about 150 - 200 cc in breast volume, this cannot be transferred to breast surgery every time. When breast lifting is added to the factor mix, the amount breast skin tightening directly competes with the adequacy of blood flow to the breast skin and breast lift incisions.

In my opinion, you should have a cooperative, working relationship with your Plastic surgeon NOT an adversarial one. Just as marriages must be based on trust and those full of suspicion cannot last, your relation with your Plastic surgeon must be honest and respectful. The moment you see it as adversarial the trust is gone and there is no point in going back.  I would communicate directly with the surgeon and in a respectful way tell him that you are disappointed and see what can be done. You may be liable for facility fees, anesthesia and implants but most surgeons would not charge you a surgical fee for such a revision. Find out.

Good Luck.

Dr. Peter A Aldea


Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Lift and implant exchange

It is very diffiuclt to size up the volume of implants and the actual bra cup size. Bras are all made differently.  Talk to your surgeon and his staff about you concerns.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

LIft and upsizing of Implants can be difficult

View this problem as two procedures, The implant by nature sits behind the breast tissue and or chest muscle and pushes  things out, or a force that is inflating the tissues. View the lift as skin is being removed or the amount of tissuethat gets removed is actually   tightening things. These 2 forces are working against each-other. I am surprised that your surgeon could have put in that much bigger of an implant and still performed an appropriate lift. You can go bigger later, wait six months or more and then discuss going larger. Lastly, we want to know if you are unhappy, don't feel you are being confrontational, just state what is bothering you and your surgeon can discuss with you what the options are. good Luck

Charles Virden, MD
Reno Plastic Surgeon
5.0 out of 5 stars 70 reviews

Breast Implant Exchange Expectations Not Met

As you can read pretty much all of us are saying the same thing but here's my two cents anyway.  I too do not talk about cup size because the formula used to determine cup size is different between manufacturers.  So I like to talk about proprotion with your body.  I think it's important that the breasts are proportionate to your shoulders, hips and buttocks.  Some women do prefer to be larger and that can be possible.  I agree that you need to increase around 150cc to increase a "cup" size.  If I were your surgeon I would tell you to allow things to heal over several months.  If you're still unhappy I would do the revision but you would be reponsible for the cost of the implants, OR and anesthesia.  After a few months you might be quite satisfied with the appearance of your breasts.

Christopher L. Hess, MD
Fairfax Plastic Surgeon
4.4 out of 5 stars 33 reviews

Breast Implant Exchange Expectations Not Met... Now What?

I wholeheartedly agree with Dr. Johnson.  I would now recommend that you have a face to face discussion with your surgeon and let him/her know exactly how you feel.  You will need an exchange with larger implants, and the two of you must come to an agreement as to what would be fair.  Good luck!

Amy T. Bandy, DO, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 106 reviews

Breast Implant Exchange Expectations Not Met... Now What?

Sorry for your unhappiness. If I were your surgeon, I would offer (again in my personal practice) an exchange to at least a 450 to 475 cc Hp at my costs under local with mild sedation (this should costs if salines approx. $1200).  Also I would have a written informed consent that you are aware of there is never any guarantee. If than you are still unhappy you may than realize your expectations can not be achieved. Best of luck. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

It would have been impossible to give lift and much bigger breast

During the breast lift some breast skin is removed to firm up the breast and reposition the nipple. This will work best with the same size implant. Your surgeon could not use much bigger implants because of the limitation of the soft tissue coverage.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.8 out of 5 stars 122 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.