My Question Is... Would Going from a 540cc to a 640 Cc Be a Drastic Change or Would It Be a Minimal Change? (photo)

Question

I'm having my implants redone. One of my saline implants raptured about 2 weaks ago after 4 years. From day one after my first surgery I said, I should of gone a little bigger, going from a 34b to a D cup. I don't want to look like I have two hard balloons, and want to look as natural as possible as I did with my first surgery, but want a little more fullness on top. I'm 46, 5'3, 137lbs

Jeffrey E. Schreiber, MD, FACS · Answer

Thank you for including the photos, but it's hard to give you an exact answer with examining you first. Going up 100cc will most likely not be a drastic change, but it also might not give you enough fullness at the top. In order to get a natural look with more fullness at the top, you may need silicone implants placed under the muscle with a possible lift. Since you've had the implants in for so long, a lift might be required to increase the fullness at the top of the breasts. Having done many breast augmetation surgeries with larger implants such as yours, I believe you can get a very nice result. Good luck! Dr. Schreiber, Baltimore plastic surgeon

Larry S. Nichter, MD, MS, FACS · Answer

One hundred cc's difference is 3 1/3 shot glasses or about half a cup size (differs from patient to patient). The amount of native breast tissue and the thickness of your fat layer, whether you have rippling presently are all important factors. If you want to stay with saline implant I would recommend considering the IDEAL implant which is the newest technology saline implant made to feel similar to a silicone implant. The Ideal Implant®, a new breast implant FDA approved and now available to the public, promises to change all of this. The Ideal Breast Implant is a saline implant with the natural feel of a silicone implant made possible by its innovative double-lumen design. This design consists of a series of nested shells which control the flow of liquid inside the implants, giving them a more realistic feel than standard saline implants.The Ideal Implant has completed its two-year trials with stunning results. Of the 472 women who came in for two-year follow-up examinations, patient satisfaction for those who received the Ideal Implant as their first implants was 94.3%. Satisfaction among women who received Ideal Implants as replacements for their previous ones was 92.3%. Surgeon satisfaction with the results was also high (96.5% for primary implants and 93.4% for replacements).See the below link for more information. Regarding size: It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon.

Kevin G. Rose, MD · Answer

You should consider increasing the projection of your implants. I'm assuming you have Allergan 510 Style 68MP saline implants filled to 540cc. That would mean the dimensions of your implants is about 14.4 x 4.6cm. If this is true then I would switch to 650ccHP silicone with a similar diameter, 14.2cm but a projection of 5.9cm. This avoids future rupture issues with silicone and give more volume in the form of projection instead of getting wider. Wider breasts will make you look top heavy and maybe even "chunky". adding projection to a breast can have a slimming effect on a womans figure.

Christopher J. Davidson, MD, FACS · Answer

Thanks for the question and photos. Without a more involved discussion, it is difficult to know what you mean by drastic. That being said, the photo of you in a bikini shows two large implants, and I am not certain if your torso could "accommodate" larger implants. In my book, 100 cc is a big difference and I would just have a discussion with your plastic surgeon about your goals and what is the largest implant he/she feels can be placed. Best of luck!

Curtis Wong, MD · Answer

doesn't produce day and night differences but you will be fuller. Since you have to have surgery, its certainly an opportunity to change things. Size with external sizers and include the volume of your deflated shell to get an idea if it will provide you the look you desire.

Darryl J. Blinski, MD · Answer

Posted clothed photos are not helpful. So can not really offer an opinion. Best to either repost nude frontal and side view photos or seek in person second opinions.

Tom J. Pousti, MD · Answer

Thanks for the question and pictures.  One of the main factors in achieving patient satisfaction with breast augmentation surgery, is careful communication. The problem with words such as “drastic change or minimal change" is that these words can be interpreted differently by different people.

	 I think that you will be best off spending time with your plastic surgeon communicating your goals carefully. Show him/her what you mean by “a little more fullness on top”. In my opinion, this is best done in front of a full length mirror and/or with the help of goal pictures.

	 Again, this in-person communication will be key and much more helpful than the specific implant advice you receive online.

	Best wishes with your upcoming procedure; hopefully you will be very pleased with the outcome.

My Question Is... Would Going from a 540cc to a 640 Cc Be a Drastic Change or Would It Be a Minimal Change? (photo)

Answers (7)

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