397cc, moderate plus, implant exchange - is it reasonable for me to still have surgery for newer implants? (Photos)

There is generally a narrow range of implants that are a good size for your frame. Saline implants can be replaced with silicone alternatives. Benefits of silicone implants are less visible rippling and lighter weight for an equivalent size. Other ways that you can safely 'go bigger' are to choose a higher profile implant (this adds volume in a different dimension that is not dictated by your frame) or to do a hybrid augmentation that combines breast augmentation with fat transfer.

Thank you for your question. A large portion of my practice is dedicated to revision breast surgery. You definitely can go larger if you would like. 397 cc is a moderate profile Allergan product. Because you have significant wrinkling, I would go to a higher profile-either a full/high profile or ultrahigh profile to minimize the wrinkling. Additionally, if you are on top of the muscle-subglandular placement then I would reposition your implants into a submuscular placement to minimize wrinkling as well. Best wishes to you.

Thank you for your question. If you are unhappy with the appearance of your breasts, then you can undergo an implant exchange. The rippling that is apparent can be mitigated with various techniques. You can change your implant to silicone and consider using an implant that is more cohesive. You can move the implant to partially under the muscle, the rippling is likely due partially to the fact that your implant is sitting above your muscle. And/or you can consider fat grafting to help camouflage that area. Lastly an acellular dermal matrix can be used again to camouflage that area. Good luck.

Dear Cheerful616835,
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

Do not go larger, since these have stretched your thin tissue even more thin. I would suggest going down in size and tightening your pockets laterally.

Dear Cheerful,

Your motives for changing your breast implants are a little bit unclear. If it is merely because your implants are 11 years old, it may not be a reasonable request. If it is to help improve rippling and provide a size increase, it might be reasonable, as there are implants that better help to avoid rippling. Keep in mind however, that any breast implant has a possibility of rippling in a thin patient such as you. An in person examination to determine your tissue characteristics would be necessary to decide if an upsizing is possible. Good luck!

You look like you have a good size but not maxed out. I'd suggest switching to gel and maybe higher profile if you want to add some volume and minimize the wrinkles.