Can I go bigger and still be tasteful? (photos)

I currently have 440cc smooth round saline under the muscle implants. They are 14 years old and starting to be less equal and have fallen a little. I want to go to silicone implant but struggle with what size to do. I want to go a little bigger (noticeable but not overboard). I've had my consult and surgeon says he will revise the sides of my pockets because my implants slide down the side when I'm on my back. Is 550 or 600 HP a good choice? I'm 5'0 and 120lbs.

Doctor Answers 6

Can I go bigger and still be tasteful?

Thank you for the question and picture.  Yes, based on the photograph and description of goals, it sounds like you are a good candidate for upsizing of breast implants along with adjustment of the breast implant capsules (capsulorraphy).
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, 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. I have found that the use of words such as “natural” or "D or DD cup” or "tasteful" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.  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). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient.
I hope this, and the attached link (dedicated to larger breast augmentation surgery concerns), helps. Best wishes.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Can I go bigger and still be tasteful?

Thank you for your question.  I think 550 cc might be the max for me in this situation but I would need to conduct an exam to be sure.  Be careful about going too big with your frame as it may increase the risks of future problems (i.e. capsular contracture, deformity).  If your implants slide laterally to the side, you would also need a pocket revision as you've mentioned.  Finally, you have a noticeable asymmetry with your right inframammary fold being lower than the left side.  This may have to be raised as part of your revision.  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

Can I go bigger and still be tasteful?

Yes, you can go larger. From the photos it appears you need more volume near the breastbone and more in the upper breast for proper shape and balance. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Increasing implant size

Replacing old saline implants for newer silicone implants is a very common procedure.  A size change (up or down) can be performed at the same time.  In my experience, to make ANY noticeable increase difference in size, a volume increase of 50% over the old implant size is necessary.
In this situation, the old implants are 440 cc, so 50% of 440 is 220, which when added to 440 equals 660 cc total.  So, I would say yes to 550-600 cc for the new implants, in fact you might be a little too small.
Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 75 reviews

Could I go larger and still be tasteful?

Dear Tropigal,Saline implants typically look a little bigger than silicone when identical sizes are being used, so it makes sense to go larger even if you wanted the same look. Additional volume can also help to fill the superior aspect where you current implants are deficient. While a 600cc implant is really big for an initial augmentation, a jump of 100-150cc is not unreasonable for a surgery like yours. Be clear to your surgeon that your concern might be ending up too large so they do not push it beyond what is needed for a good result. Your breast shapes are starting off fairly asymmetric so there might be a need to raise the nipple on the photo's right, or remove some skin inferiorly on the photo's left for improved symmetry. Best of luck!

Stacey Folk, MD
Denver Plastic Surgeon
4.8 out of 5 stars 24 reviews

Bigger and still tasteful

Thank you for your question. It is difficult to give you any definitive answers without examining you in person and taking measurements of you breasts. I would start by saying that being 14 years old, your implants are due for an exchange. You have developed some asymmetry based on your pictures, I wonder if you have a tighter capsule on the right side, you might have a bit of contracture there. If your implants are sliding outward, you will definitely need a revision of the lateral pocket to tighten that up and make sure they don't slide anymore. With regard to size, I would hesitate to go too much bigger given your small frame. Your chest/breast dimensions are what dictate what size implants we can place and still look natural and tasteful. Once you try to push the tissue to beyond its limits, you will start to see unwanted changes like thinning of the skin and breast tissue that develope over time and are difficult to fix. I hope this helps.

Fadi Constantine, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 10 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.