Implant exchange saline to silicone. Wanting to downsize. Would 375cc get me the size I desire?

Question

I currently have 400cc SALINE mod + implants filled to 450cc. I am wanting to downsize around one cup size. At my consultation, we decided on 375cc SILICONE gel mod + with pocket tightening (current implants are 13 years old and have “relaxed” quite a bit). My surgeon thinks this should get me the result I desire, as saline tend to appear about 50-75cc larger than the same size in silicone. Would you agree that 375cc will get me the size I desire? If not, what size would you suggest?

Daniel Barrett, MD · Answer

Dear Terrific509044,
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

Connie Hiers, MD, FACS · Answer

Saline and gels are the same size if filled to the same volume. Profile can make then seem fuller. To go down one cup, I would suggest going with 300-325 cc's.  A cup increase is usually 150 cc's.  However, if you go too small, you may need a lift. Your surgeon can best tell you what size is best.

Karl William Schwarz, MD · Answer

Any change in implant size should be done by at least 100cc otherwise you really can't notice a change. So for patients that wish to increase their breast size and they have 400cc implants they should go to at least 500cc or they won't really appreciate a change. And the larger the implants are to begin with than the more the increase should be--in other words if you have a 550cc implant it is probably best to move to the 700cc range in order to get a noticeable change in size. Where as if you had a 250cc implant then that same change will be noticeable at 350cc.

Here is the math:
Change from 550cc to 700cc is 150cc
150cc/500cc 30% increase

Change from 250cc to 350cc is 100cc
100cc/250cc 40% increase

Here is the math:  
Change from 550cc to 700cc is 150cc
150cc/500cc  30% increase

Change from 250cc to 350cc is 100cc
100cc/250cc  40% increase

Implant exchange saline to silicone. Wanting to downsize. Would 375cc get me the size I desire?

Answers (3)

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