When Will I Know my Final Size? Lift With Augmentation and Small Reduction.

It takes about three to four months for your breasts to settle. At that time you can better assess your results. Generally speaking, there is a minor decrease in size once swelling subsides, however it is difficult to say by exactly how much. 

This seems to be an unfortunate trend among some of my plastic surgical colleagues. You had adequate size (actually slightly large, since you asked for "smaller, perkier" breasts), and a breast lift alone would remove about an ounce of skin, or a bit more tissue if indeed you wanted a bit smaller. Why add implants at all if you were already bigger that you wanted?

The sad answer is that some surgeons were apparently trained that in order to do a breast lift, more than on ounce of tissue "must" be removed. I and a significant number of other ABPS-certified plastic surgeons know this is simply not true. When one of my patients likes her breast size and simply wants a lift, I remove 15-30 grams of skin (1/2 to 1 ounce) per breast, and tailor the remaining breast skin to the desired lifted, "perky" appearance. No more tissue needs removing, and implants are not "needed" to "shape the breast" or give the desired "upper pole fullness," which is the usual "excuse" or explanation for why implants are recommended.

A properly-tailored skin brassiere gives a perfectly soft and natural uplifted and "perkier" pair of breasts, and a push-up bra can give her even more uplift if she wishes. Having an unnatural projection and "Baywatch coconut" upper pole is neither natural nor attractive, but it is indeed something a few (misinformed, IMHO) women ask for. A soft, natural breast is best, and has the capability to be molded into any shape a woman's bra and clothing are capable of. Hard round breasts are, well, hard and round, and cannot be soft or natural regardless of clothing choice. And they really look weird when nude!

But that's just my point of view; strongly held.

Unfortunately, you had 80-100g removed and 250cc added per side, so no matter how things settle and soften as swelling goes down, you will be 5-6 ounces bigger per breast than when you started, though in an uplifted, perkier package. Hopefully, your surgeon gave you a nice skin tailoring breast lift--you will end up with larger, more youthful breasts. 

In my opinion, if you were clear you wanted only a lift and wanted to be slightly smaller in a perkier skin brassiere, you should not have had implants (or the cost, time, increased healing risks, and potential concerns related to them).

Again, this is my opinion, but it is hard to understand the rationale for your surgeon's choice, at least based on what you state. Your surgeon, of course, is entitled to his/her own opinions, and presumably has your best interests at heart, not increased fees/cost. I just feel s/he is misinformed or poorly-trained; otherwise, unethical is the only remaining option.

It sounds as if you may require more surgery to remove the unwanted and unneeded implants, hopefully without having to re-do part or all of your lift. All three of my patients in the web reference below (click on the link to see the cases) had only skin removal and breast lift, no implants. Sorry about your plight. Dr. Tholen

   Placing implants is typically not advisable if the patient is wanting to have a reduction in bra size.  The lift and small reduction can be performed without an implant.  Kenneth Hughes, MD Los Angeles, CA

I'm sorry to hear of your recovery but simple math will tell you that an augmentation that exceeds the volume of reduction will result in a larger volume (aka bigger breast).   You should be discussing your concerns with your surgeon and better understand the logic behind the decisions.  Did you select your implant size or did you leave this up to your surgeon?  Now that its 'water under the bridge', you can either resolve this with your surgeon or get a second opinion with your surgeon's consultation/notes available for review by whomever you select for your second opinion.

Something is here that I don't understand. If you wanted to be smaller and perkier, why not just a lift. 

It is not likely that you will wind up smaller if 80 to 100 grams was removed and 250 cc added. That should account for about a cup size increase in size, not a decrease. 

You may or may not have any swelling, but I don't see how you can wind up smaller than you were with 150-170 cc net enlargement. Discuss with your surgeon. All the best. 

I am not sure how much smaller you will get because it really depends upon where you started. If he removed 100 gms and put in  250 then you are plus 150 which may add a cup to where you started.  Wait for the swelling to subside.

By 6 weeks after the surgery you should have a significant reduction of the swelling after the surgery. It takes about 6 months to actually see the implants settle in place. If your breast are still very large in size by this time the may not reduce in size much after this period. I f you needed any revision you should wait at least 6 months to a year.

Good luck

To directly answer your questions, your breast size after 1 month is usually pretty accurate as to what you will be in a year though you may slightly go down in size if you had more swelling than average. One cup size is approx 150-250 cc depending on your size. Based on you losing 100 grams (approx 100 cc) and gaining 250cc I would suspect your final cup size to be approx 1/2 to 3/4 larger than your preoperative size. Thus a full C or borderline C/D.

Thank you for the question. You are still early on in your recovery. In the initial phase after surgery there is a period of inflammation and scarring that must occur in order for you to heal. Over the next 6 months these processes will subside and your breasts will start to "settle" as the implants drop and the soft tissues of the breast accommodate.

No one can tell you how much of what you see is due to the inflammatory process and thus temporary. However be assured that that your breasts will continue to change over the next 6 to 12 months.

I recommend that you not fixate on a "cup size" as it is more of an idea than an actual number. Just think of when you buy bras. One can buy 2 "identical" bras, yet they will not fit the same. At this juncture I would encourage you to be patient and continue to follow up with your plastic surgeon. If after 6 months you remain unhappy with your results discuss it with your surgeon.

I hope this helps. Best of luck.

Thank you for the question.

 Your plastic surgeon will be your best resource when it comes to meaningful advice and/or reassurance. As you can imagine, it is not possible to provide you with anything but generalities online.

 Generally speaking, breasts do change for the first  6 months to one year after breast surgery.  Although I do not think that they will change “a cup or 2” in size,  it is safe to assume that changes will occur.

 I would suggest that you continue to be patient and continue to follow-up with your plastic surgeon. I would also suggest that you do not base your level of satisfaction with the procedure performed on achieving a specific cup size. As you know, cup sizes will vary from one bra manufacturer to another.

 Best wishes.