Implant Exchange 360cc Saline SG for 469 Cc SM-will This Achieve my Desired Results?

I am 5'4" 120 pounds with a 30" ribcage 360cc saline subglandular implants that are rippling and migrated to the sides after 9 years. I want to go a little bigger and more natural (I.e. Not the grapefruit look) with mod profile silicone submuscular. My doctor recommended 469cc implants. Will this achieve the desired results? I am a distance runner but wear 3 sports bras when I work out so there is no movement at all. My main concern is the exchange of projection for width on my small frame.

Doctor Answers 5

Choosing implants

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Without an exam it is difficult to offer you suggestions. The exam will help evaluate your anatomy and based upon your goals the appropriate implant could be selected.

Remove sub-glandular & replace sub-muscular ?

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At Lake Tahoe Plastic Surgery patients choose a PlayBoy photo of the size they want to see in the mirror post-op and that determines wether they need a skin reduction (lift) or an even larger implant to get that result. I would expect you to be disappointed with the procedure you describe unless your skin is very tight already. Any laxity and 100 cc larger will not prevent sagging of the breast gland off the new sub-muscular implant mound. Every patient is different and your question cannot be answered accurately without and in the flesh exam. My first impression would be for you not to restrict your surgeon to a specific cc size. It may require 200 cc larger to get the result you want without ugly fallen nipples.

Lawrence Foster, MD,FACS,FICS

Lawrence Foster, MD (retired)
Sacramento Plastic Surgeon

Have a clear goal for breast augmentation revision

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The new submuscular pocket may help give better coverage and stop the migration to the side, and yes the 469 is a little bigger, perhaps big for a distance runner. Three jog bras, really? The point is you should be clear and let your surgeon know just what the look should be, and not be hung up on the numbers. A 'little bigger' is not much to go on.

Implant Exchange

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Without an exam or at the very least good photos standing and reclining, it's hard to answer you specifically. However, the change to subpectoral smooth midprofile gel implants approximately 100ccs larger than your current implants sounds very reasonable. You may still need a reduction in the size of the lateral pocket.

Achieving Desired Results with Revisionary Breast Surgery?

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Thank you for the question.

It is not possible to give you precise advice without direct examination or viewing pictures. However, based on your description, consideration should be given to repair of the breast implant pockets (capsulorraphy) to prevent migration of the breast implants to the sides when you lie down.  This may or may not be necessary since you are exchanging the breast implants to the submuscular  position.

In regards to achieving desired breast size/projection, it will be important to have a  detailed discussion and communication regarding your desired goals  with your plastic surgeon. This communication will be critical in determining which operation and/or breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or "huge and fake” etc means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.

Once you feel you have communicated your goals clearly,  allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals.  Again, in my practice, this decision is usually made during surgery.

Best wishes.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.