Looking to increase breast size following uplift and 250cc - is 500cc - 600cc's possible? (Photo)

Question

Around 2 years ago i had an uplift with implants and I’m not happy with the size or shape of my breasts. I was advised 250cc and told bigger was not possible. I would like 500cc-600cc i am tall and medium size frame sp 250cc looks very small on me. I would like my breasts to be closer together with more upper pole. I would like to avoid another uplift but I am not happy with the shape of my nipples and the scars around them.

Robert M. Lowen, MD · Answer

Dear Emily,
  Thank-you for your question about revising your scars and getting bigger implants.   I agree that 500+ implants would better suit your frame.  I do not see any problem with doing that.  Your nipple to fold distances are too long, and you would therefore also benefit from a revision of your breast lift to improve the scars around your areola and shorten the distance between the nipple to fold to no more than 9.0 to 9.5 cm.  If  you have stretched out since your mastopexy/augmentation,  I would also consider adding some inferior pole mesh support to decrease stretch after the next procedure.

Vasileios Vasilakis, MD, FACS · Answer

Hello,
Thank you for the question. From the photos, you need revision of the breast lift to optimize the scarring and nipple position. In terms of the implants, it is possible to increase the size but not as large as 500 cc.
I wish you the best. 
Vasileios Vasilakis, MD, FACSDouble Board Certified Plastic SurgeonHouston, TX.

Daniel Barrett, MD · Answer

Dear emilyella24,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. 
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Mehmet Ozdemir, MD · Answer

I completely understand the frustration of feeling like your first surgery didn't meet your goals, especially when you have a taller frame that can easily carry more volume than 250cc. To achieve the upper pole fullness and closer cleavage you're looking for, moving into the 500cc–600cc range is certainly anatomically possible, but it is rarely as simple as just swapping the implants. Because you are unhappy with the current nipple shape and scarring, and because significantly larger implants will put new tension on your skin, you likely do need a revision mastopexy (lift) to ensure the nipples are properly centered on the new, larger mounds. Attempting to stretch your current "lifted" skin envelope with a 600cc implant without a surgical adjustment could lead to the "bottoming out" effect or further distorting your nipple shape. I recommend a high-profile silicone implant to give you that "pop" at the top, combined with a pocket reinforcement to help bring the implants closer to the midline for that integrated look you desire.

Waylon Zeng, MD · Answer

Hi there thank you for sharing your story and your photos. I understand you recently had a breast lift and implants placed, but you are unhappy with your result. From the photo, it looks like the scars around the areola has stretched out. Additionally, it looks like the breast tissue is now starting to fall off the implant into a lower position. This is a consequence of the surgical technique, the weight of the implant, and your skin stretching out. It’s likely that your skin quality is not adequate to maintain the weight and size of the implant, so it is causing the skin to stretch out. 
A larger implant would improve your cleavage. While I think 250 is good for your frame, I think 500-600 would be very large. 350-400 would provide a fuller result. Additionally, the hanging breast tissue would need to be removed as it is starting to stretch. This could be combined as a revision breast lift to fix the shape of your areola. In your situation, internal mesh bra may be advantageous to prevent the implant from stretching out the scars and skin. I hope that helps!

Mats Hagstrom, MD (license on probation) · Answer

In order to assess the outcome of your procedure, you should ideally include proper before and after pictures.
It looks like your implants are bottoming out just slightly.
I think if you end up going with very large implants, you’re going to have problems and end up needing multiple revisions And endless re-operations.
I recommend you keep your current size and don’t go bigger.
Using excessively large implants will always increase complication rates, and the need for revision surgery.
Best,
Mats Hagstrom MD

Looking to increase breast size following uplift and 250cc - is 500cc - 600cc's possible? (Photo)

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