Size of implants impact complication rate?

Very good question!The larger the impacts the higher the complication rate especially in the long-term.There has also been a recently published article that studied the effect of larger implants on the spine.>400cc was associated with changes in the spine.As someone who sits on the patient safety and public education committees fort he American Society of Plastic Surgeons, I commend your thought process.The best way to assess and give true advice would be an in-person exam.Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.best of luck!Dr Schwartz

This is an interesting question and one that is not discussed enough, in my opinion.  Implant volume does affect complication rate, but not necessarily capsular contracture.  Larger implants are more likely to rupture over time, more likely to bottom out or suffer other malposition, and more likely to ripple and/or be noticeable upon palpation.A 300cc implant is a very reasonable size for most women, and should keep you free from elevated levels of rupture, malposition, etc.  Sientra's latest data shows an elevated rupture rate above 360cc (2.7% vs 2.1% at ave. 6.5 yr follow-up) for example.Capsular contracture is much more dependant upon surgical technique, and, to a lesser extent, implant texture and position above/beneath the pectoralis.  

Hi,

Thanks for posting your question. I am happy to try and help you. It is
important to remember that a board certified plastic surgeon will be your best
resource when it comes to an accurate assessment of your situation, and
concerns.

Having said that, yes, smaller is better.

Best wishes,

Dr. Michael J. Brown
Northern Virginia Plastic Surgeon

Hi, jgmj. Thanks for your question.  I like implants to be proportional to the body.  As implant size increases, it has higher risks for ptosis (sagging) and displacement.  300cc is not a big size to give you an increased risk.  Good luck with your surgery. 

The short answer to your question is - Yes. To begin, I think it would be useful to classify the potential complications as either:



Medical (allergic reactions, nausea, etc)

Surgical (poor scarring, pair, numbness, infection, bleeding etc), or

Implant related complications, which can be further classified as either:




Those related to stretching of the tissues




implant malposition

palpability

rippling

thinning of the overlying breast tissue

implant exposure and extrusion, and

re-operation



Other (implant rupture, capsular contracture, animation)





Larger implants will increase your risk of implant complications that are secondary to stretch deformities of the tissues. In my opinion, some element of tissue-based planning should be employed during the sizing process. The measurements taken and observations made during tissue-based planning will help to ensure that you stay within a relatively safe range of implant size that minimizes your risk of complications. 

It is always best to match the size of the implant with the body that it is going into. That being said, a good rule of thumb is the larger the implant the greater likelihood there is of complications. Patients with overly large implants often return for lifts, treatment of capsular contracture, and other revisional  procedures. They can also develop the same symptoms that women who are seeking breast reduction often complain of, including neck pain, back pain, grooving in the shoulders from the bra straps, and rashes under the breast. 

This is a question that plastic surgeons wish more patients would ask. 300 cc's would generally be considered a conservative size for most patients. Considerably larger implants, especially those that do not fit a patient's based with / chest wall measurements, are more likely to result in malposition complications such as synmastia and bottoming. Larger implants, especially those that do not fit a patient's measurements may also result in an increased risk of sensory loss to the nipple areolar complex.  I do not think there has been a proven association between larger implants and capsular contracture.

You are right.  Smaller implants that meet your need are the way to go.  300 cc is a reasonable size.

In general terms, the larger the implant, the higher the rate of complications such as implants bottoming out or moving side ways out of the pocket.  Issues like capsular contracture have not been associated with implant size.A 300 cc implant is not considered a very large implant and, as long as it fits your breast and chest dimensions, should not pose an increased risk of complications.  Hope this helps.

You pose a great question. Within reason, larger implants do not have more complications. However, if you try to use implants that are too big for your body, you are likely to have more complications such as bottoming out, and symmastia (uni boob). Capsular contracture is not more common in larger implants. An in person consultation with a qualified plastic surgeon is the best way to determine what size implants are right for you. Seek
a plastic surgeon who is certified by the American Board of Plastic Surgery who
specializes in cosmetic plastic surgery, as evidenced by membership in The
American Society for Aesthetic Plastic Surgery. Ask to see many pre and post op
photos and speak with previous patients.