Is 590cc ultra high profile too big for me? (Photo)

Question

Hi. I had my first breast augmentation May 1, 2015, about 8 months ago. I was originally 34a and got 400cc uhp silicone implants. I did get a noticeable change but not as big as I would like. I'm going for a revision to increase size and doctor recommended 590. He said the skin is stretched and now I can go bigger. Just wondering if 590 will be too big for me? I would like more side boob and more fullness. Is 400 to 590 a big difference?

Craig S. Rock, MD, FACS · Answer

Based upon the photo you have provided, you appear to have a very nice result from your augmentation.  When performing breast augmentation, I utilize dimensional planning, which matches the dimensions of the implant to the patient's chest wall dimensions.  While it is impossible to know your pre- (or post-) operative dimensions from your photograph, it appears that you surgeon did an excellent job matching the implant to your chest wall.  Using Mentor ultra high profile implants, a 400cc implant has a base width of 10.6cm and a projection of 5.4cm, while a 590cc ultra high profile implant has a base width of 12.5cm and a projection of 6.3cm.  While you would achieve a noticeable increase in breast size, you will also be adding almost an inch and a half to you breast width.  Whether or not the added width would be a good match for your frame can only be determined by a physical exam; if the implant is too wide, placement would result in either a change in shape of the implant or the implant extending over the side of the chest wall.  Another consideration should be the added weight.  Replacing 400cc implants with 590cc implants will add over 13 ounces in weight,  which may increase the risk of your breast skin stretching over time, may increase the risk of back discomfort, and may cause discomfort with activities like running.Be sure to carefully consider the potential risks of benefits of the revision with your surgeon.Best wishes.

Thomas A. Mustoe, MD, FACS · Answer

You currently have a lovely shape and appearance with 400 cc.  In general in order to make it worthwhile to increase breast implant size, I would recommend going up at least 150cc, so 590 cc will achieve that goal. You will have more width to your breast (side boob), and with large implants there is an increased risk of implants dropping over time, or symptoms of back pain, which I have seen, just as in patients with large breasts who seek out breast reduction.  As long as you are aware of the down sides, you should be able to achieve a nice result, given when you are starting from.

Daniel Barrett, MD · Answer

Dear steph246,breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Darryl J. Blinski, MD · Answer

No if you desire very large implanted breasts. Try on implant sizer first!>>>>>>>>>>>>>>>>>>>>>>>>>>>

Tom J. Pousti, MD · Answer

Thank you for the question and photo. 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 breast augmentation 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 know words such as “more fullness” or "more side boob” etc means different things to different people and therefore prove unhelpful.
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 (and the attached link, dedicated to breast augmentation  revision surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Ciro Adamo, PhD, MD · Answer

Of course an examination would be needed to be able to give a precise answer, but speaking in general it should not be too big. In fact, you are only adding 190cc this time, so the change will be smaller compared with the 400cc that you added with the first procedure.

Is 590cc ultra high profile too big for me? (Photo)

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