Implants Too Small After Breast Reconstruction Surgery

I just recently had my expanders exchanged for silicone. I finished my Chemo laster year. My PS put in 450cc. I looked at my chest and they do not look big at all. I was hoping to acheive a full C cup.

My PS told me he was going to open my chest medially. I thought we had it settled what size I wanted. Im just very unhappy with how they look right now. There not big at all! Im not sure how swollen my chest is. It doesnt look swollen to me.

Doctor Answers 6

Disappointment with Breast Size after Breast Reconstruction

I largely agree with most of the preceding comments and would like to amplify on them. Please do not take my comments as a personal criticism - they are NOT intended as such.

You have a potentially fatal disease. The duty of your surgeons is to exercise their best experience to separate that disease process from you and give you a long, recurrence free life. The mastectomy process itself largely determines what the plastic surgeon can or cannot do.

As Plastic surgeons we would LOVE it if our breast surgeon colleagues would allow us to mark their incisions for them to assure the scars will not be oblique but transverse and hidden in a bra, if they left as much breast skin as possible, if they made the skin flaps even a little thicker and not paper thin (and practically devoid of a stable blood flow, if they left the under the breast fold intact (making breast reconstruction easier and more natural) and if they could refrain from radiating the breast after the surgery permanently damaging our reconstructed breasts. Sometimes these requests are followed, often they are not and when we walk in to do the reconstruction many "bridges" have been burned for us.

Building a breast is NOT a matter of just picking and plugging a set volume implant into a matectomized chest. It calls for a LOT more artistry, experience and knowing when to accept good as good enough and NOT push further and lose everything with an overly large implant which can exert too much pressure on thin breasts flaps or a weakened infra mammary fold.

Discuss this with your surgeon and see what if anything can be done. Maybe if you understood his/her reasoning you would appreciate what you have.

Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

Breast implant size

The ultimate size of the breast after mastectomy and tissue expansion will depend on many factors other than the size of the implant.

Tour weight, height, and fat distribution will play a role in the final cup size.

A 450cc implant is a good size implant, going larger will depend on the amount of tissue cover for the implant.

Remember the larger the implant the more frequent the need for further surgery.

Le the present size settle down for a while then make a decision regarding the size of the implant. At that time discuss with your PS your desires and size, discuss the pros and cons of increasing the size of the implant, fat distribution especially on the lateral chest that may cause the breast to look smaller.

Samir Shureih, MD
Baltimore Plastic Surgeon
4.2 out of 5 stars 7 reviews

Small implants after breast reconstruction

A 450 cc implants may be a nice full C cup in a patient 5'5" and 115 pounds. However the same implan6t in someone 5'6" and 150 pounds may be only a full B. In other words it has a lot to do with the size and shape before surgery as well as thesize of the chest wall to begin with.

Speak to your surgeon as you may be a candidate for an implant exchange in the future to increase the size. You may also want to wait until the new anatomic silicone implants are available. The best thing to do is to talk to your doctor so hopefully you can achieve a size you are satisfied with.

Steven Schuster, MD, FACS
Boca Raton Plastic Surgeon
4.0 out of 5 stars 6 reviews

The right size for an implant breast reconstruction

A 450cc is a reasonably sized implant to achieve a C cup. I would urge you to discuss this with your surgeon. There may be many reasons why this is a good size and should not be made any larger due to potential complications.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Implants and results

It you are unhappy with the final result of your reconstruction, you should talk with your doctor about it and try to figure out how to resolve your disappointment.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Disappointed with your Breast Implant Reconstruction - Too Small

“Where can I find larger implants for my breast reconstruction?”

Athena Study: Breast Reconstruction Study of Investigational >800cc Silicone Implants

I wanted to inform you of a new breast reconstruction study that is currently open to enrollment.

The study involves investigational, larger-sized silicone gel breast implants in ranges from 930cc to 1445cc. Currently silicone gel breast implants only are commercially available up to 800cc.

This study is enrolling women who have undergone a full mastectomy and whose body shape requires a larger breast implant. Women who either need an initial breast reconstruction or a revision of a previous breast reconstruction may be eligible to participate.

If you are interested in participating in this study, please call my office to schedule an appointment or to obtain more information about the study and to see if you qualify to participate. My office number is 912 355 8000 Please ask to speak to Catrina.  If you have any questions about this study please contact me at 912 355 8000.

Additional details regarding this study can be found via the following link to  

Thank you!

Richard J. Greco, MD

Richard Greco, MD
Savannah Plastic Surgeon
5.0 out of 5 stars 23 reviews

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.