Doctor Chose 240cc Implants and I Am Very Unhappy?

HI,

 

That size does seem very small for a women of your height, weight and stated goals. You probably would have been happier with implants in the 325-350 cc range.You should go back to your surgeon and explain your dissatisfaction and see whether he will change you to a larger size. I would wait at least 6 weeks from the first surgery to allow the scar to mature and the swelling to subside.

All my best,

Daniel A. Medalie, MD

During the consultation for breast augmentation, it is extremely important that the patient and the surgeon are "on the same wavelength" regarding the patients goals.  While proper implant sizing means that the chosen implant should be within a range of sizes in order to minimize the risk of complications, a 240 cc implant seems like it would be too small to get you from an A cup to a C cup.  I would think that 3 months would be an adequate amount of time to wait prior to replacing the implants.  Make sure you know exactly what size your surgeon is going to place this time, or consider using a different surgeon. 

     In general, 240 cc implants are small.  The average implant placed in the US is 350 cc.  Almost any woman's chest wall can accomodate 300 cc if the right profile is selected.   You can get a revision at 3 months or so.  Please find the board certified plastic surgeon with ELITE CREDENTIALS who performs hundreds of breast augmentations a year.

The part of your question that concerns me the most is the fact that you claim your surgeon was uninterested in your desires about size.  It is really important that the surgeon guides the decision but listens to what the patient wants.  I will allow my patients to select the size, as long as I do not feel that the size they are picking places them at risk for complications. I suggest you find another board certified plastic surgeon for your revision.

I am sorry to hear about your disappointment regarding your result. Selecting the right implant is one of the most important issues for breast augmentation. It a decision between the patient and the surgeon. Your surgeon made the decision that you did not agree or did you agree to allow your surgeon to make final decision? Do he or she discuss the reason for using a particular size/shape? Perhaps what's chosen is a better fit? Is there an anatomical reason that make it unsuitable for you to get bigger implant? These are some issues I think that's worth discussing with your surgeon, ideally before, not after the surgery.  I can't speak for other practices but typically in my practice, the decision is made jointly and there has to be an agreement between the patient and myself before the surgery ever take place. Revision is typically made after 6 months from the original surgery. 

Best Wishes,

Stewart Wang, MD FACS, Wang Plastic Surgery

I would recommend that you talk with your surgeon about your disappointment and discuss options for exchanging your implants for another size. As far as timing of the revision, each surgeon has a slightly different opinion on this, but typically it can be done in a relatively short timeframe.

Sizing of the implant and understanding and fulfilling patient wishes while still staying within the requirements of maintaining patient safety is the art of breast augmentation. Revisit your surgeon and discuss the issue again.

I am not surprised that 240cc breast implants are inadequate. I can not think of a single patient in my practice who would be happy with such a small size. You would be much happier with something in the 350cc range as you had already surmised. You could have a revision at any time now that you know your current size is below your expectations.

The most important part of a consultation for augmentation is communicating your goals clearly. A proportional implant is fine but the result for better or worse must be 'you'. Your implants can be exchanged early if they are not the look you wished for.

I am a firm believer in a collaborative process. Proportion is extremely important but both doctor and patient should be on the same page. I recommend that you discuss this in a constructive way with your plastic surgeon and inquire why he did not use larger implants. It may be possible that the breast pocket couldn't accommodate anything larger at this time, but that you could have a followup procedure at a later date. Timing of a revision would depend upon the reason for use of the smaller implants. If you need to stretch out, then at least six months; if a miscommunication, certainly sooner than that.