5 years later, current breast implants are still firm. Want to go bigger, how can I achieve that with a natural feel?

There are several reasons that the breasts may still feel tight. You may have a capsular contracture where the capsule has started to shrink around the implant. The implants could potentially be too large for the space. I encourage you to visit with a board certified plastic surgeon for an evaluation. She/He will advise if larger implants are okay for you as well as check for capsular contracture. Botox will not accomplish what you are wanting as it does not stretch the skin.

Dear Reserved41136,breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

One of the most common reasons for implants to feel firm is capsular contracture. After breast augmentation, your body will form something called a capsule around the breast implant. This is a part of the normal healing process. In some women, this capsule becomes tight, causing the implants to feel firm and sit higher on your chest. In severe cases this can cause asymmetry or pain. In mild cases the implants may look normal and only feel firm.
The treatment for capsular contracture is a breast revision surgery that includes either release or removal of the tight capsule. This treatment of the capsule can often be done simultaneously with an implant exchange.

If you're considering going bigger with breast implants while still aiming for a natural feel, there are several factors to consider and discuss with your plastic surgeon:
1. Implant Type: Opt for implants with a natural feel, such as silicone implants. Silicone implants are known for their softness and can provide a more natural look and feel compared to saline implants.
2. Implant Shape: Consider using anatomically shaped implants (also known as teardrop-shaped implants) instead of round implants. Anatomically shaped implants mimic the natural slope of the breast, providing a more natural appearance.
3. Implant Placement: Discuss the placement of the implants with your plastic surgeon. Placing the implants under the muscle (submuscular placement) can help create a more natural look and feel by providing additional tissue coverage over the implant.
4. Implant Size: Work closely with your plastic surgeon to select the appropriate implant size based on your body proportions and desired outcome. Going too large may compromise the natural look and feel, so it's essential to find a balance that achieves your goals while maintaining proportionality.
5. Preoperative Simulation: Some plastic surgeons offer 3D imaging or simulations to help you visualize the potential outcomes of different implant sizes and shapes. This can be helpful in making informed decisions about the desired size and achieving a natural look and feel.
6. Discuss Expectations: Have an open and honest discussion with your plastic surgeon about your expectations and desired outcome. They can provide valuable insight and guidance based on their expertise and experience.
7. Follow-up Care: After surgery, follow your plastic surgeon's postoperative instructions carefully to optimize healing and achieve the best possible outcome. Attend all follow-up appointments to ensure proper monitoring and address any concerns promptly.
By carefully considering these factors and working closely with your plastic surgeon, you can increase the likelihood of achieving your desired result of larger breast implants with a natural look and feel.

There are a lot of factors that can play into this... it depends what type of implant you have now, where the implant was placed (above or below the muscle) and if your body has formed a thickened capsule around the implant. You should be able to go up in size, but the best way to get an answer would be to see a board eligible/board certified plastic surgeon so they can evaluate your breasts with you and address your concerns. Botox does not help with stretching of skin.