Average Cost for Going Bigger After First Breast Augmentation?

Question

3 Weeks ago I received breast implants. 350-375cc HP. I am unhappy with the size-they are too small. I expected them to be bigger on my frame. I tried on 375 cc sizers and they felt and looked significantly bigger... Is this because now they are under my muscle? I still feel like my breasts are small and I am considering having surgery again to go up at least 100 cc because I am just not happy with the size. Typically, how much would this cost? How long should I wait?

Robert M. Lowen, MD · Answer

One of the main reasons for re-operation after breast augmentation is failure to achieve the desired size. Size revisions are usually to go larger. If the size is perceived as too small soon after surgery, accurate determination of how much larger to go is going to be made more difficult by the swelling that lasts at least two months.  One should wait a while for the swelling to go down, because you want to be as accurate as possible the second time around in determining the size you feel is ideal for you.

	Using implant sizers usually results in a very close approximation to the size that makes the patient happy. Women can choose a variety of sizes and find the range in which they feel they are too big, too small and just right. My experience shows this is true when the implants are under the muscle. Feeling that you need to go up at least 100 cc means that this process did not work well for you, however.

	I recommend a patient wait several months before acting on a desire to have a re-augmentation for size. Most women who want to be a "little" bigger become accustomed to and accepting of their augmentation and do not want to have the expense and slight inconvenience of a re-augmentation (recovery is minimal).

	There is also a computer imaging tool that can supplement the decision-making process done with sizers alone, crisalix imaging, which I use in my practice.

	The cost of the procedure includes the new implants and the facility and anesthesia fees which are slightly less than the initial augmentation. Any surgical fees would depend on your discussion with your plastic surgeon, such as any pre-operative discussion you might have had of what your surgeon's policy is on charging for re-augmentation for size.

	In general the cost is going to be less than the original operation. If you go to a second surgeon, the cost will likely be similar to the cost of the original operation.

Ira H. Rex III, MD · Answer

Each office would have their own policy regarding this, but I charge fully for a new augmentation. Size change decisions by the patient are under little or no control by the surgeon. I basically cover my work after a breast augmentation for one year if more attention is needed. In my practice, size changes are not covered. From my perspective, they are actually more difficult surgery with higher complication rates.

Mathew A. Plant, MD, FRCSC · Answer

It's tough to know why exactly your breasts look so much smaller than they did with the sizers without having been there for the sizing, but on average things appear 25cc or so smaller once you put the implant under the breast tissues. Three weeks is a bit early to judge your results, its best to wait at least 3 months before considering a revision. The pricing to increase your size would typically be discounted a bit if you are with the same surgeon but exactly how much of a discount would be up to them. I'd suggest booking an appointment with your surgeon to discuss your concerns.

Daniel Barrett, MD · Answer

Dear kris03,I understand your concern and it is quite normal to be concerned about the outcome following a breast augmentation surgery. However, you are still in the very early stages of the healing process at 3 weeks  post op.Your will need to be patient at this moment and follow what your surgeon has instructed you to do post operatively.At the early stage of the healing process, the tissues around the implants are still swollen. Once the swelling subsides and the implants drop to their final position, you will be able to see the final result of your breast augmentation surgery.The cost of surgery depends on a lot of factors (type of surgery, number of treated areas, anesthesia fee, surgeon, facility fee, city, etc.). It would be the best to discuss this with your plastic surgeon. Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Jed H. Horowitz, MD, FACS · Answer

Yes, it is possible to #increase your implant size with a #revision. However, the #pocket may require adjustment and a lift may be necessary; to better #support the new implant depending on an evaluation. Additionally, a mesh for further support may be helpful depending on the #implant size and skin #elasticity.Typically, it's best to wait 6 to 12 months depending on the reason for #revision.  Matters such as sagging or drooping  and size change will not improve with time. As with all cosmetic surgery, results will be rewarding if expectations are realistic. With any surgical procedure, there are some risks which your doctor will discuss with you during your consultation.The #costs of #BreastRevision are contingent on several factors. Such as geographic location, the skill and experience of the surgeon, and operating room and anesthesia fees. Also, different breast implants may have different costs. The approximate costs can be found here on the Real Self website, Surgery.org, or PlasticSurgery.org.Your procedure should always be performed by a #PlasticSurgeon who is board-certified and has a great deal of experience specializing in cosmetic #surgery. You will then greatly improve your chances of getting the result you desire, and, without the need for another revision surgery. It is suggested that you look at before and after photos of the surgeons actual patients, and read patient #reviews. Gathering all of this information will help you make a well-informed decision.

Larry S. Nichter, MD, MS, FACS · Answer

It might be too early to consider a breast revision at this point in your recovery. I usually tell my patients that you are about 85% of the way to your final result in 3 months and achieve it by one year. Your final results following a breast augmentation are mostly present; including "dropping of the implant", when implants are below the muscle, within the first 3 months for most and certainly by a year. Breast implants initially after surgery when placed in a sub muscular position often give superior fullness that corrects itself with time, the "fluff and drop" phenomena. In reality the pectoralis major muscle takes a while to adjust its size to accommodate the implant as well as occasional muscle spasm which keeps the implant projection higher than its final resting shape. Additional variables include: laxity of skin, size difference during prior pregnancies, position of implant, size of muscle, and size of implant. As the muscle relaxes the projection of the implant often increases and the breast shape improves. Massage and use of a superior placed elastic strap can often make this process go faster.The price varies greatly by geographical location, experience of the surgeon, whether in an outpatient surgery center vs hospital (hospital more expensive), type of breast implant, etc.

Kenneth Hughes, MD · Answer

If you want to go larger, you should increase the volume by at least 100 cc or you may be disappointed again. The cost will probably be lower if you remain with the same surgeon. The implants can be exchanged at about 3 months or so depending upon individual healing characteristics. Kenneth Hughes, MD Los Angeles, CA

Ronald J. Edelson, MD · Answer

I always tell patients that the implants seem smaller when they are in place then they do when you place them on the outside of your chest. This is even more so the case when they are placed under the muscle. The best way to get a good price on going larger would be to go back the original surgeon. Maybe they would cut you a deal. If you go to a new surgeon, it will probably cost you about the same as the first procedure.

Kris M. Reddy, MD, FACS · Answer

Typically, you do not want to assess the surgical results for at least 6 months as swelling makes it more difficult to understand the size and shape. Implant exchange like other cosmetic surgery varies considerably across the country and even in the same area. South Florida tends to have lower fees then more expensive areas such as New York or Los Angeles. We charge $2800 + MD Anesthesia related costs for implant exchange with saline implants. Gel Implants tend to be about $1000 to $1500 more. Since you can get quality work at lower costs, patients will travel from throughout the state, the country, and internationally to have surgery in South Florida. To ensure that you are receiving quality work at the most cost effective prices, consult with board certified plastic surgeons that own their own nationally accredited facilities. The quality must be maintained at the highest level to maintain accreditation. The surgeons also have incentive to hire and train quality staff (to ensure that surgery is efficient and enjoyable), to ensure comfortable and private facilities (to encourage referral), and to eliminate waste (to ensure that these facilities can compete effectively).

Tom J. Pousti, MD · Answer

I'm sorry to hear about your disappointment after breast augmentation surgery. Your case is however illustrative and may be helpful to other patients.
	 Generally speaking, I think it is problematic to try and decide exactly what size/profile of breast implants will best meet a patient's goals preoperatively. Despite a variety of modalities available preoperatively (all of which made the helpful but not precise enough), I think the  breast implant size/profile decision is best made during surgery after the use of temporary sizers with the patient in the upright position.
	 

	At this point, given that you are not happy with the breast size, I would suggest that you communicate these concerns in a calm/constructive fashion with your plastic surgeon. Communicate your goals clearly;  as you know, this communication is key for every patient undergoing breast augmentation or breasts revisionary surgery. In my practice, I find the use of goal pictures helpful during this communication process.

	Also, keep in mind that many patients initially after surgery will feel that their breasts are too small or too large only to be quite pleased with the outcome of the procedure performed several months down the line. Therefore, unless you are absolutely certain, best to wait approximately 6 months before evaluating the results of the procedure performed and deciding whether additional surgery is worthwhile.If so clear communication of goals will be important to avoid further   dissatisfaction.

	 Best wishes.

Average Cost for Going Bigger After First Breast Augmentation?

Answers (15)

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