Should I Discuss a Possible Size Revision with my Surgeon and is It Fair to Have to Pay Again for What Was Already Requested?

It has been 2 months after my breast augmentation. I've had a great and very quick recovery, not to mention a great surgeon. Lately I am feeling VERY unhappy with my implant size. I am 5"2, 100lbs and petite frame. My surgeon chose Natrelle Style 15, 339cc's placed behind the muscle through a periareolar incision. I went from a 32A to a 32D, however I feel that they look small, especially in clothes. I brough LOTS of pictures to my surgeon and explained I was going for a Salma Hayek look.

Doctor Answers 10

Breast Implant Size Revision

In our office, a great deal of time is spent trying to determine what size of implant will give the patient the look that she is trying to achieve. It is a proactive process where the patient tries on sizers under her clothes, and from that, we try to determine which implant size will come closest to accomplishing her goal. The hardest—and most important—thing for a surgeon to do is meet the patient's size expectations.  Also, there are always physical limitations, pocket site dimensions, nipple location, and skin; all of these factors and others could limit the ultimate size one is trying to achieve.

Ogden Plastic Surgeon
4.7 out of 5 stars 25 reviews

Patient Responsible for Surgical Revisions in Most Cases

After Breast Augmentation - Still Want to be Bigger - Who Pays?
I'm glad that you are in general happy and love your plastic surgeon - i.e. you have a great patient-physician relationship.It sounds like you have a great plastic surgeon.  If you want a change then by all means let him know. He might discount a subsequent procedure to make your breast's larger but that would be as a favor as ultimately you would be responsible for these costs.Here is the explanation -

Your Plastic Surgeon did listen to your wishes and  responded appropriately  by increasing your cup size significantly after seeing photos and a full consultation with you. Going from an A to a D cup is a big change..Cup size is anything but an exact science. Did you give him a photo of the relative size you wanted?  Please note that it is impossible to guarantee that a specific cup size will result from any patient's breast augmentation as to some degree this is an arbitrary measurement differing from manufacturer, bra type or even which hook you fasten..  Cup sizes are highly variable and are not a predictable end point of breast augmentation.Often during surgery the surgeon is faced with quality issues vs quantity. In my mind quality should always win as a beautifully shaped breast is more important than a large but unattractive one.
I also want to comment about the fact that the majority of Plastic Surgeons only guarantee their best surgical effort and experience to give you the best results they are capable of but they do NOT Guarantee a final result. Guarantees that you will be happy with the results, and that there will not be any problems afterwards is being unrealistic.
Plastic Surgery is an inexact science and art form. For example it is not like carpentry where you can measure and make a piece of furniture over and over exactly the same both immediately after you finish and in the future. All surgery has risks which the surgeon may not be able to alter. You as a patient need to understand, and it is the plastic surgeon's responsibility to make you aware of the risks associated with this procedure. This is called "informed consent". Most plastic surgeons (all surgeons for that matter) would agree that that it is important for the patient to understand that what they are paying for is  the best possible effort using all of their skill and experience to achieve your goals.There are no direct or implied guarantee of results as too many variables exist between patients (such as loss of elasticity, underlying muscle imbalance, sun damage, prior trauma, smoker, anatomic variation, etc, etc).

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Usually no professional fee for a breast augmentation revision.

The vast majority of women who have a breast augmentation wish afterwards that they had gone a bit larger.  Almost never do they choose to have another operation.  My policy is to not charge the patient a professional fee since we both share the responsiblity of choosing the size the patient wants.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.7 out of 5 stars 35 reviews

Costs of Revision

Each office has a different policy regarding revisions. Speak with the surgeon, and I am sure that you will be able to reach a mutually fair solution. With your petite frame, you will need to ensure that you are not seeking an appearance that will not be suitable.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 39 reviews

Cost for revision breast surgeries

You just need to have a conversation with your surgeon to answer your question. You are not the first person that wished that their implants were bigger after breast augmentation surgery. It is in fact a very common thing to happen. So common that your surgeon likely has a policy in place to handle this issue. The key to avoiding frustration with the results of surgey is to have a very clear understanding about limitations and expectations of a surgical procedure. If your surgeon was not clear with you before surgery about the possibility of you feeling the way you do now about your size, then it might be appropriate to ask for a reduction in the cost of an implant exchange. Usually, this would involve a waived surgeon's fee for the procedure. Believe me, your surgeon wants you to be happy. If, however, you were aware that your body type might not be able to handle the size of an implant that you wanted and that a smaller implant was more appropriate for you, then it might be more appropriate for you to cover all of the costs. You did after all have a good experience with good results. Communication is the key.

Wm. Todd Stoeckel, MD
Raleigh-Durham Plastic Surgeon
4.9 out of 5 stars 84 reviews

Implan size revision

Without pictures it is difficult to say, but from your description it sounds like you are a petite person.  Please remember that when implants go beyond a certain size relative to you natural breast volume and base dimensions, the result will be increasingly unnatural.  From my perspective that is not a good trade-off.  Unfortunately our society bombards us with reality TV and other distortions that cause us to lose our judgement of what looks good.  This is the only explanation I can provide for why so many celebrities have such strange results from their surgeries.  In my opinion, it is better to have a natural looking breast, than a cartoon of a breast.

John Q. Cook, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 12 reviews

Implant choices and fees

The office policy is something to talk to the office staff about. I would imagine that the surgeon wants you to be satisfied. My guess that you pay for new implants and the facility fee would be required. Possibly he will not charge you for a surgeon's fee. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Discuss your concerns

I'm happy to hear of your quick recovery and that you are pleased with your choice of surgeon. With regards to your implant size, it is best to sit down and have an open conversation with your surgeon. Your surgeon wants you to be pleased with the look of your new breasts and would encourage you to discuss your concerns with them. Just remember that an exact look (i.e. Salma Hayek) is a not "100% guarantee" as your frame and body size are not exactly like Salma, though your surgeon will work with a desired look. I am doubtful that a revision will be free of charge as there are anesthesia and OR fees that are associated with any operation, but I am sure your surgeon will be as accomodating as possible with a secondary surgical fee.


Good luck,


Dr. Ken Dickie

Size revision

It is very good to know that you are pleased with the result, other than size, and had a good recovery. Begin by discussing tne size with your surgeon in a nonjudgmental way. You are petite and this may have limited the size of the implants. Remember that everyone`s body is different. I personally did not think that Salma Hayek was terribly large breasts. Also photos can be deceiving and she may be wearing a padded bra. If these were implants that you selected, then you will have to pay for revision but it is possible that your plastic surgeon will charge a reduced fee.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 39 reviews

Implant Size Revision for breasts that are "too small" 2 months after surgery.


2 months is not a very long time after your initial surgery. Your surgeon's size selection resulting in a 32D breast for a 100lb. and 5'2" women seems appropriate. Go back and discuss your size expectations with your plastic surgeon.

Matching implant size selection to photos of other women is not a predictable approach to a satisfied patient.

Large size breast implant selection is often limited by the patient's breast size, shape, and position. If too large an implant is placed in a small breast, the risks of rippling, displacement, and a visible implant are dramatically increased.  There is no substitute for your plastic surgeon's experience and judgement.

With careful measurement and breast examination, we inform our patients of the maximum implant size that, we feel, can be safely selected. We then have our patients try on implants in bras during their consultation and they select the size that they are most comfortable with. This helps our patients meet their size expectations.

Best Regards,

Douglas J. Raskin, MD
Colorado Springs Plastic Surgeon
4.9 out of 5 stars 62 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.