Is it worth it to go up 50cc? (Photos)

Any time you are on the fence about elective plastic surgery, don't do it. I would recommend waiting until the answer becomes clear to you. Once you have a procedure, you cannot take it back. If you are happy with your current size and shape, there is no reason to go in for an increase in size. Also, I'm not clear on what you mean by "upgrading" the breasts. Do you mean increasing the size, or changing to new implants, or simply adding volume to your current implants? Adding volume to give a tight feel is not a reason to have surgery, since that tight feeling is temporary, and only lasts as long as it takes your skin to relax around the larger volume. It is very rare for an implant to get exposed after a standard breast augmentation, so I am wondering if there were other factors were involved (hematoma? infection? trauma?) In the photo the breast volume appears asymmetric, and it also looks like there are incisions related to a breast lift, not just an augmentation. If there is asymmetry, this may be a reason to go back in, but it is hard to answer the question without getting the full history and doing an exam. While online forums are a great way to get information, photos do not take the place of seeing a plastic surgeon in person, and it may be a good idea to get a second opinion. Please make sure you seek out a plastic surgeon who is certified by the American Board of Plastic Surgery and has experience doing breast implant revisions.

Going up by 50cc is not worth it.  It will not be all that noticeable.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Hello, There is more to your story than you probably know. Implant removal that early almost always has to do with implant infection, which is not caused by too much lifting. You clearly have peri-areolar incisions, and I highly recommend you and your surgeon avoid using them again, given the risk of re-contaminating your new implants. I think you should get a second opinion from a few ABPS certified/ASAPS member surgeons who specialize in revision breast surgery. Best of luck!

Thank you for your question photos. I have found it in order to make a meaningful difference, usually at least 100 mL per size necessary. I would listen to your surgeons input, but realize that 50 mL will likely make very little difference in your ultimate shape and size. Best Regards.

Without examining you it's difficult to give specific advice but if you felt your breasts weren't as "perky and tight" with the 350cc implant as you wanted then adding 50ccs may make a difference. The best way to judge is to try the implants at a sizing session and see if they look right. Hope that helps!

It probably will take going up by 75 to 100 cc at least, in order for you to appreciate the change. Exposure may have been the result of a tight skin envelope with skin breakdown, sutures pulling through, etc. but also could have resulted from infection contaminating the space. In any event, I think 450 cc, assuming your breast envelope can tolerate it, is more likely to give you a meaningful and visible change to justify going back through surgery after previously having had a complication. As another surgeon has pointed out, periareolar incisions for straightforward augmentations have a reported higher risk of capsular contracture than inframammary scars. The issue I see with just switching to an inframammary is that you look like you had an attempted Bennelli (donut) lift judging from the scars going all the way around the areolae. Aggressive periareolar lifts are associated with areolar and scar widening and could certainly have explained the incision opening up as the skin tries to retract to its original location. You may need conversion to a lollipop (vertical) lift in order to redistribute the tension and get a better aesthetic result on the areolae. In that procedure, the implant exchange could be done through the lower portion of the vertical incision, avoiding contact between the nipple area and the new implant for lower risk of capsular contracture.

If you're completely happy with your intact implant, why change it?  It only increases your risks and costs assuming your costs will be less if you just focus on your side that has no implant.  If you want to be fuller (even if not much of a huge difference), then go for it.  But more bothersome is your feeling that you caused the wound to separate... just what were you doing that allowed that to happen?

 I am sorry to hear about the complication you experienced.   Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, in bra sizers, and computer imaging)  as well as careful measurements (dimensional planning) will be critical. 
 Generally speaking, the best online advice I can give to ladies who are considering revision surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “50 cc more" .Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this helps. Best wishes for an outcome that you will be very pleased with.

Adding 50 cc makes little to no difference in breast size.  If your surgeon suggest 400 cc’s over 350 cc’s, follow his advise,  as most likely he has measured your chest and feels confident in his recommendation.