Breast Implant Size Advice for Revision Due to Encapsulation?

I am having a breast augmentation revision due to encapsulation of my right breast following pregnancy. I want larger breasts as I currently have 320cc implants. I have some excess skin. Would 500cc be too large? My surgeon wanted me to have a breast lift and smaller implants but I like big boobs!

Doctor Answers 10

Breast Aug Revision

Thanks for your question.  Having large implants without a lift and small implants with a lift will likely give a very different aesthetic result.  It depends more on what look you feel will be best for your own situation versus what someone else thinks is best for you.  If you like larger breasts that is fine but if you have significant droop to your breasts already, adding larger implants will only add weight and eventually cause more droop.  If you are okay with that look don't get a lift.  If you are not okay with that look you need to discuss having a lift with your surgeon.

Phoenix Plastic Surgeon
4.8 out of 5 stars 46 reviews

Breast Implant Size

The more breast surgery I do the more I realize that there is no correlation between the size of implant and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 

Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
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 press 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.
By the way, the most common regret after this operation, is “I wish I was bigger”.

I hope this helps.

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

Breast Implant Revision

It is possible that a lift will help with the sagging skin. The size of your implants is a decision that you and your surgeon should agree on together. It looks like you are hoping to increase your implants by about a cup size. It is important to pay attention to your specific measurements which will affect your final result. Talk to your surgeon about your desired outcome.

Joseph G. Bauer, MD, FACS
Atlanta Plastic Surgeon
4.3 out of 5 stars 23 reviews

Increasing implant size

Increasing the implant size after removal of a capsule is certainly an option. However, the larger you go, the more likely that the lift will not hold them up for long.

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

Increasing the size of your implants

The large increase in size of your implants will give you a pretty good lift, but keep in mind that you may need a formal lift several years down the line. The larger implants will increase the amount weight pulling down on the breasts each day. Check out some before and after pictures of larger implants to see if that's what you really want instead of smaller implants and a lift. Good luck!

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 201 reviews

Breast implant revision (remove and replace) with a larger implant

It is likely that you will be able to tolerate 500cc implants in the short term. However, there may be long term concerns such as tissue attenuation, stretching, thinning, drooping (ptosis) and interference with nipple sensation that should also be taken into consideration when selecting a larger implant.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Choose a surgeon that does a lot of breast implant revision

i do many breast revisions for patients. It is important to go to a Board Certified Plastic Surgeon who is used to doing revisions. Hard to give you a good answer as you need to be examined. 500 cc may be too large as the other surgeons have stated. It depends on the elasticity of your skin. The bigger you go, the more likely it can sag over time.

You most likely will need the implants removed and the scar tissue removed (fulll capsulectomy. You need to be examined to see if the pocket position needs to be changed (under or above the muscle). But doing a lift will help if you have a lot of skin.

Go to a Board Certified Plastic Surgeon.

Good luck!

Andrew T. Cohen, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 42 reviews

Big breast implants age very badly.


1) Your surgeon is right. 500 cc implants will make your sagging worse and worse over time. I have seen a lot of unhappy women who went down this road. I am sorry, because I know this is not what you want to hear.

2) You may find it useful to look at the breast augmentation page on my web site.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Breast Revision Surgery

You have a complicated problem and you need to listen to what your surgeon is telling you, if you trust their judgement ofcourse. I would always seek a second or third opinion in breast revision surgery as there are different views on how things should be done.

But just remember bigger implants had a higher contracture rate, and given the fact that you already have had capsular contracture, your chances of having the contracture again are higher than the next person.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 77 reviews

Big breast implants or little implants, if you have drooping breast then you need a mastopexy .

You have actually three different issues and they need to be addressed separately. As to the hardness, capsular contraction, you need to have the implants removed, the scar tissue removed and the implant replace in a different pocket if possible. If you have saile implants under your mussels I would recommend textured silicone gel implants under the breast. If you have silicone gel under the breast i would recommend silicone gel or saline implants under the muscle.

As to the loose skin issue you need to have the shape of your breast evaluated and the location of your nipple areolar complex be determined in relationship to your inframamarry crease. If there is just a skin excess and the nipple areolar complex is about or at the inframamary crease then you can have an implant that will refill the excess skin or a peri areolar reduction of skin with the new implant. If the nipple areolar complex is below the inframamry crease then you will need to have a breast lift to change the position of the nipple.

As to the size of your implants there are limits to the recommended size depending on the base diameter of your breast. With a high profile implant you can go larger with a smaller base diameter. The thickness of your breast tissue must also be considered in the location of the implant and the size of your implant.

Carl W. "Rick" Lentz III, MD
Orlando Plastic Surgeon
5.0 out of 5 stars 15 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.