I am 7 months post op, and went for my pre-op revision yesterday. I am looking to have a much fuller look with more projection. When I spoke with my PS about this, he told me that he didn't think he could put 750 in. When I asked why he said he doesn't think he can stitch me back up... So he said he would try but more than likely I would end up with 600-650 maybe 700. He said he would play with the sizers while in surgery. I am not to happy about this! How can I get him to put in what I want? And is this possible? Also, will I achieve the look I am going for with anywhere from 600-750 hp silicone's verses the 390 overfilled 425 saline mod profile I have? Thanks a bunch.
Going from 425 mod profile to 600-750 hp? (photo)
Doctor Answers 17
Increasing size of implant
This is a common issue. You want a certain size and your Plastic Surgeon is concerned that the size implant you have chosen will be too large. I think that if your PS is willing to test out the size you want during surgery with sizers, then you should trust his professional opinion. However, if you are adamant that you want a certain size implant, then you may want to consult with another board certified plastic surgeon.
It is our job to put the patient's safety first and to minimize the risk of complications.
Breast Implant , Safety, and Revisionary Breast Surgery?
Every good plastic surgeon has one priority on his/her mind: safety. If your plastic surgeon feels that the use of a specific size/volume of breast implant would compromise the safety of the operation ( for example, not be able to “stitch you back up”) then as a patient you have 2 options. The first would be to respect his/her professional opinion; the second would be to seek a 2nd opinion consultation with a well experienced board-certified plastic surgeon.
Make sure you do not “push” your plastic surgeon in trying to use a breast implant that is too large for your friend; doing so will increase the risk of complications and the likelihood of further surgery will be necessary.
I hope this helps.
Going from 425 mod profile to 600-750 hp?
If an implant is so large for your skin envelope that the surgeon cannot close the incision, it is not possible to have this implant. You must also realize that the larger the implant, the greater the risk over time of irreversible skin stretching and thinning that may be difficult to correct. Patients sometimes think they want something but do not realize that there are consequences in terms of healing complications, poor scarring, and deformity that can lead to additional surgeries and significant expense.
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Implant Size Increase
Part of a surgeons job is to do what is, in their opinion, best for the patient. Unfortunately, sometimes the right thing for a surgeon to do isn't always what a patient thinks they want. The body has limitations. It is likely that your surgeon is recommending what he/she feels is the best to achieve a good outcome for you now and in the long-term. Best Wishes!
Secondary Breast Surgery to Increase Size
There are very few "rules" regarding size increase as long as your body is large enough to accept the increased breast size. With 425cc implants in place you should be able to get almost any size you wish with the only limitation being the implant diameter. Sometimes when dealing with sizes this large it is better to have the fill options available with saline implants. It is usually easier to get the projection and size you desire with high profile saline implants filled to the upper limit of the recommended fill range.
Can I Replace 425cc Implants With 700cc Breast Implants?
With indwelling 425cc implants, you should have no problem placing 700cc implants or more if that is what you want. You have a fair amount of breast skin to begin with and it has been expanded with your first set of implants. By volumetric addition, that is a 75% increase in volume which is well within the range of what your expanded pockets can accomodate. They should be high profile implants so that the base of the implants does not get too wide.
Going from 425 mod profile to 600-750 hp?
I am advising from a different position. Over the internet very hard to advise the specifics of size and over sizing. Why have u=you not seen more in person consults??
You Can BUT Should You???
If changing to a much larger implant it makes sense to go from a moderate profile implant to a high profile implant because the base diameter of the larger implant is more likely to fit your chest dimensions. A 750 cc high profile silicone gel implant has a base diameter of either 15.2 or 15.0 centimeters depending if you go with Mentor or Allergan...compare that with a 650 cc implant with a base diameter of 14.4 or 14.2 centimeters respectively. The difference in base diameter between what you want and what he suggests is less than 1 centimeter!
While I'm not an advocate of huge breast implants and you should be limited by reason and the dimensions of your figure, I think you could probably get away with 750 cc but I think you'd look much better with slightly smaller implants. Make sure your surgeon and you are on the same page so that you avoid unnecessary disappointment later.
In our practice we have gone as big as too 900cc. It’s up to the surgeon and what he feels comfortable doing. It is the patient’s choice they are the ones living with them. Make sure you get what makes you happy.
Size of implants during breast augmentation revision
Have done thousands of these. Can get in almost any size implant on almost any body but it may not look too great.
In your case, you have plenty of tissue. The difference between the 650 cc implant and the 750 implant is not even 7 tablespoons (15 cc per tablespoon). No chance of having difficulty here. (50 cc is just over 3 tablespoons)
Having said this, your plasctic surgeon might be trying to tell you his opinion about going this full. I personally have no issue with it but some do.
I used to use 8oo cc implants in some delayed mastectomy patients...go figure.
You are doing the right thing. Make sure that you and your surgeon are comfortable with his approach and go from there. Going up from where you are is going to be significant and going to the high profile is going to give you more projection.