Advice for revision to go bigger? (Photos)

I had my BA 1 year & 3 months ago and haven't been happy with the size since pretty early on. I'm 5'5" 130lbs, but wasn't told my BWD. My Dr. had me try on 339, 371, 397 sizers & said 421 was the biggest I could go and wouldn't do High Profile, so I went with 421cc Mod+ silicone submuscular. I look much smaller than the 421 sizers looked, and I'd like to be bigger with more upper pole fullness. I feel that 500-550 HP would achieve what I'm wanting. Is this reasonable?

Doctor Answers 12

Advice for revision to go bigger?

Thank you for the question. Online consultants will not be able to provide you with specific enough advice to be truly helpful. 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, and computer imaging) will be critical.  



Generally speaking, patients undergoing revisionary breast surgery should understand that there may be many variables besides breast implant volume that come into play when determining optimal  breast implant selection during revisionary breast surgery.  For example, adjustment of the breast implant capsules may be necessary; this adjustment may be a factor when it comes to selection of appropriate breast implant size/profile.  Lots to factors to consider...



Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation 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 “reasonable” or "D or DD cup” 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.  Personally, I find it most beneficial to have a wide range of breast implant types, sizes, and profiles available.

I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.  

Revision to go bigger

Hello, and thank you for your question and great pictures! I do believe that your goals are reasonable and attainable. I would want to take exact measurements to confirm the size I would recommend, but I do think using a fuller implant in all dimensions would help to achieve your desired look. Good luck!

Ashley Gordon, MD
Austin Plastic Surgeon
4.9 out of 5 stars 31 reviews

Bigger implants = bigger potential problems: what to know

In general the larger the implant, the more likely there will be issues such as sagging and rippling. However, an option you may wish to consider is the Inspire implants, which have a higher fill ratio so you essentially get more volume without pushing the base diameter as much. Plus there are 5 profiles to chose from instead of the 3 with the type of implants you have now.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 48 reviews

Going bigger

Hi.  Yes, I think you can achieve more upper pole fullness and generally be larger if you go with a HP 500-550cc implant.  I'd be happy to give you an opinion face to face if you want to come for a consultation.  Best of luck!

Jonathan Heistein, MD
Fort Worth Plastic Surgeon
4.9 out of 5 stars 22 reviews

Advice for revision to go bigger?

I think those are reasonable expectations and wish goals for you. You have a little bit wider cleavage that the pics you show in your vision board pics. I like to use sizers in this type of situation. It is really crazy but sometimes it is hard to know how that 500 will look. I do feel high profile for sure and maybe even ultra high profile In patients who have a narrow breast base diameter who want to be bigger, they need a narrow implant and the ultra high profile implants can do that. That allows the surgeon to stay in your breast base diameter but get the volume you need. I always try both profiles when I am not sure and pic then that fits the breast and looks closest to my patients goals. You may take way bigger then 550 if yo have 421 now. That is only 129 cc difference and you are looking at several cup sizes bigger in the pictures you post. I wold not be surprised if it too in the 600's to get you there, but again until I am in the operating room and just try I never know. Sometimes small women swallow big implants and it just takes more. Good luck!

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 45 reviews

Exchanging to larger silicone implants.

Though I think you have gotten a very nice and natural looking result, if you wish to change to a larger implant you have allowed an adequate period of time for skin relaxation and changing to a larger implant becomes quite possible.  I would be thinking of a larger diameter mid-plus profile implant but a high profile implant may work as well.  The larger diameter will enhance your cleavage with and without bra support.  Enjoy your results but I would advise you to avoid too extreme a change due to the fact that excessively large implants do have detrimental effects over the course of time. Specifically, the risk of displacement, thinning, palpable or visible rippling and waviness do go up as the implant becomes heavier and larger.  Best wishes,

Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
ABC-TV Extreme Makeover Surgeon
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

Size

You have a very nice size now, but could go larger since your tissues have been stretched and settled. However, larger is heavier and may give you some discomfort in your neck and shoulders. Over time, larger has a great tendency to sag. I would suggest going back to your surgeon and discussing all your concerns and options.

Connie Hiers, MD
San Antonio Plastic Surgeon
4.6 out of 5 stars 13 reviews

Advice for revision to go bigger?

Thank you for your question, and excellent photos. From the numbers that you've provided, I believe that you have Natrelle style 15 moderate-plus profile implants in place. Your post-op photos demonstrate excellent placement and symmetry. However, all of your 'wish' photos show more medial and upper pole fullness, which is easier to achieve using larger volume, higher-profile implants. 

The 421cc style 15 implants have a listed diameter of 13.3cm and projection of 4.3cm. If staying with the same manufacturer, the Natrelle Inspira SRF full profile implants have listed dimensions of 13.5cm diameter/5.7cm projection at 560cc, and 14cm/5.8cm at 605cc. I would recommend that you discuss with your plastic surgeon whether these, or similar implants from another manufacturer would better meet your goals. The good news is that you had a very good surgical result with your first procedure, which gives you a great starting point for re-augmentation. 

Michael F. Bohley, MD
Portland Plastic Surgeon
4.9 out of 5 stars 15 reviews

Wanting to go bigger

Thank you for your question.  If you want to look bigger, 500-550cc would be a reasonable range based on your current implant size.  Keep in mind that your breasts are more wide apart compared to the breasts in your wish pics; this can be improved but won't look exactly the same as your wish pics.  Be sure to consult with an experienced board certified plastic surgeon.  Good luck! 

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

Breast augmentation exchange

hello and thank you for the question and the photos. When deciding to go larger, the best advice is to do the rice test at home. add dry rice to a ziplock or old nylon stocking and keep adding volume until you reach your desired size. For most women, at least 150cc increase is needed to see a noticeable difference. The average padded bra from victoria secret will give most women the appearance of about 150-200 cc of added size. 

The goal pics you posted do indeed look like high profile and that would probably be the better choice for you. 

You should have several consultations with board certified plastic surgeons before making any final decisions. 

As always, best to be healthy, no smoking, and make sure any health concerns you have are managed by your primary care md. 

Best to you

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 17 reviews

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.