Should I increase from 350cc to 600cc, or more for bigger, rounder and more cleavage? (photos)

Your breasts have descended down the chest wall, laterally and are bottoming out.  Adding larger implants will make your situation much worse.  At this time, I recommend explantation using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation and the ability to breast feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.  Implants are not lifetime devices and half are removed by 9.5 years.  Fat transfers are permanent and incorporated into the body.Best Wishes,Gary Horndeski, M.D.

Thank you for your question and providing photos. Based on your photos it appears you would benefit from a breast lift procedure. Changing to 600cc implants will not lift your breasts. In fact they would probably sag even more. Best of luck

Without examining you it is difficult to be certain but based on the photos if you were to upsize your implants you would not likely need a lift. The nipples sit above the inframammary creases already and if you increased the size of the implants they'd come higher up on your chest than they are now. The only way to know for sure is to book a consultation with a board certified plastic surgeon near you to see what your options are. Best of luck!  

I would caution against such a drastic upsize. This is only likely to worsen the issue and not provide a lift. Alternatively, I would recommend a formal mastopexy. If an exchange is planned it should be for an implant of greater profile and not necessarily significantly greater volume.As always, discuss your concerns with a board certified plastic surgeon (ABPS).Donovan Rosas MD
Board Certified by the American Board of Plastic Surgery
Member: American Society for Aesthetic Plastic
Surgery, American Society of Plastic Surgeons
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Based on your photos, I think you would have an excellent outcome with a few things wrapped up into a single procedure. You would benefit greatly from a revision with pocket contouring (tightening), placement of bioresorbable mesh to support the pocket and the new implant, implant exchange (higher profile/narrower base width), and a mastopexy. Just putting in larger implants will likely lead to bottoming out, droopiness, and need for more surgery. Good luck!

The ideal breast you desire will not be obtained by simply enlarging the implant.  If your implants are under the muscle, larger implants will simply push your breasts further laterally where you do not need it.  It is impossible to determine how much nipple ptosis you have from the pictures, but if you had significant displacement and needed a mastopexy, you have enough breast tissue and fat to remove the implants completely and reshape the breast in the hands of a skilled surgeon. After lifting the breasts, you can always enlarge it with implants later after the wounds are completely healed and soft.  No bridges are burned, but complication rates for each operation are less than 1%.  Combining a mastopexy and enlargement increase complication rates significantly because one is a shrinking operation and the other is a stretching operation. Bigger is not better.

A board certified plastic surgeon will be able to guide you to the correct size implant for your measurements and desires.  Measurements of the chest wall and breast imprint width as well as knowledge of all breast implant sizes and profiles should make this process easy. The average volume in the US is 350 cc.  I would recommend that you go with the size that boosts your self-esteem, and fits your anatomy.  Thin women who select large implants can encounter complications such as thinning skin and loss of sensation.  The weight of the implants can also lead to sagging, stretchmarks, and back issues over time.  Choosing an implant based upon an aesthetic goal that exceeds your anatomic capacity may lead to complications and possible revision. Kenneth Hughes, MD, ABPS Board Certified Plastic SurgeonLos Angeles, CA

Good morning,
Yes if done properly you can go to 600cc. I would perform a donut mastopexy to lift your nipple position and tighten your skin, the Internal Bra, my strong permanent internal suturing technique to lift and support your larger implants, and the implant exchange!

going with larger implant would make your breasts too large and stretch the skin out over time.  A breast lift would be reasonable but be aware of the scars involved.  Trying a lift with 600 cc implants will almost certainly give a poor result and I strongly advise against doing so.

Dear amyashby86,
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