I Currently Have 360cc Saline Implants, I Am Having my BA in 9 Days. My Doctor Recommended 500 or 500c? (photo)

I am currently a small c and i wish to be no larger than a small d.I am 5'9 130 pounds.I had my previous BA in 2005 through a armit incision.My implants sit a little high,but i have some sagging due to breastfeeding 2 children.I am hoping to achieve more fullness on the lower part of my breast.My doctor recommended 500-550 cc moderate plus or high profile silicone implants.I would prefer a more natural look.I am having a hard time deciding what to do.Please help

Doctor Answers 10

In the ballpark as long as you go High Profile

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Saline and Silicone implants behave and size very differently. Saline stands more proud or has much more projection that a similar size and profile of silicone. I would always recommend a high profile silicone to replace a saline implant, and amazingly have to increase by at least 50-100% in volume. In fact I just took out 250cc Mentor Saline and replaced with a Allergan style 20 500cc HP implant in a very thin, fit, kick boxing instructor who was VERY concerned about being too large and she said the results exceeded her expectations.  I would caution against a 500cc moderate plus profile and think a 500-550 HP would look fantastic. I believe the implants you have now sit high because of the completely submuscular placement, also notable is the lack of inferior medial roundness from pec insertion and would recommend conversion to a dual plane placement through an inframammary approach if you were my patient.

Increased breast implant size.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

The diameter of your "breast pocket"  (from edge of breast bone to the side of your chest) should match the "base diameter" of your implant of choice.Another consideration in the choice of implant size and type  is how much your skin/breast tissues can be stretched .  Added projection, resp. fullness can be achieved with increasing size to moderate profile or high profile.This all together should give you what we call  a "natural look".

As you can tell I did not mention any particular size or  particular implant as the right "size" is what looks finally the best for you. What you consider "natural" I cannot judge.

Therefore as suggested elsewhere go back to your surgeon and discuss and show him pictures what you "really" want.

The bigger the implants the heavier they are and your tissues have to "hold" the weight for the years to come.

Good luck!

I Currently Have 360cc Saline Implants, I Am Having my BA in 9 Days. My Doctor Recommended 500 cc or 550 cc?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

   Going up 140 cc is not an reasonable amount.  I typically recommend going up at least 100 cc so that a difference is perceived by the patient after an upsizing.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast implant revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.  Kenneth Hughes, MD Los Angeles, CA

I Currently Have 360cc Saline Implants, I Am Having my BA in 9 Days. My Doctor Recommended 500 or 500c?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Than I recommend UHP 500 cc silicone implants as a compromise. But you need IN PERSON evaluations! Please. 

Increasing breast implant size

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

You are planning to increase your breast implant size by 140 cc this will be about a 2/3 to 3/4 of a cup size increase.  If this is your goal then you should get a nice final result.  

Goals of revision breast augmentation

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Your goals and what you prefer is the most important consideration when contemplating revision of your breast augmentation.  Your current implants do sit high with the pointed projection just above the nipple.  Repositioning a fuller implant properly centered in the breast should give you a much improved result.  The degree of fullness is your call so make certain your surgeon clearly understands the right look for you so that he can decide on the correct implant to get you there.

Breast Implant Revision

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Although I do not have any measurements of your breast width, your photo indicates a somewhat narrow chest wall.  If you want to look natural, I would suggest getting an implant that fits your dimensions rather than focusing on the end volume.  Please keep in mind that even though you would like the lower portion of your breasts fuller, a 500cc implant is also going to make the upper portion of your breast fuller.  Discuss all your options with your plastic surgeon before surgery.

Lawrence Enisman, MD, FACS
Albany Plastic Surgeon

Revision Breast Augmentation Surgery

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

Sizing is always challenging and even more so when a patient has implants. In my practice, and I speak for myself, I encourage my patients to go up minimum 100cc if they are truly want to see a difference. Anything over that is their decision. You are quite tall so 500cc isn't unreasonable but truly only you can decide.

Achieving Goals with Revisionary Breast Augmentation Surgery?

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

I think that you will benefit from  additional time spent with your plastic surgeon. No online consultant  will be able to advise you as precisely as your own plastic surgeon can while you are standing in front of a full-length mirror. Demonstrate to your plastic surgeon what you would like to achieve and what you consider “too big” or “too small” with the help of goal pictures as well. Do not use cup size as a reference;  this form of  communication can be a source of confusion. The term " natural” can also mean different things to different people.

 Based on the limited information and picture you have posted, I would share your concern about 500 mL implants achieving a “natural” look;  again, make sure that you clarify your goals carefully prior to proceeding to the operating room.

 Best wishes.

BA in 9 Days.

{{ voteCount >= 0 ? '+' + (voteCount + 1) : (voteCount + 1) }}

For patients who have not had breast surgery, I like to have them try on implants and use that info along with anatomic measurements to  choose the proper size. That doesn't work in someone who already has implants. What is helpful is to do a "rice test", filling stockings with varying volumes of raw rice, and using a sports bra find the better volume between the two options (or another volume if better).

Based only on the one frontal photo, I wouldn't want to make a guess. Best wishes.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.