What is the best size silicone implant for a secondary augmentation with mastopexy to gain upper pole fullness?

I had a 2nd breast augmentation with mastopexy after 2 children. My results are not what I had anticipated. One side has dropped creating a natural look and the other side is high, which is giving me the upper pole I wanted. I previously had 500cc/550cc saline implants. They have been replaced with 400cc/425cc silicone implants. I have expressed to my Dr that I am dissatisfied. He suggested replacing the implants with 600-650cc. I'm concerned that I still won't get what I expected.

Doctor Answers 5

What is the best size silicone implant for a secondary augmentation with mastopexy to gain upper pole fullness?

Thank you for the question. You will find that online consultants will not be able to provide you with specific advice in regards to selection of specific breast implant size/profile.  Sometimes adjustment of the breast implant capsules (capsulorraphy) and/or additional breast lifting may will also be necessary to achieve an outcome that you will be happier with.

Ultimately, careful communication of your goals (in my practice I prefer the use of goal pictures, direct examination/communication in front of a full-length mirror, and computer imaging) will be critical. 

Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery (regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work. 2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining 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 "D cup” or "upper pole fullness" 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.  3. 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 ( after the use of temporary intraoperative sizers). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient.

I hope this, and the attached link (dedicated to larger breast augmentation surgery concerns), helps. Best wishes.

San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Post op augmentation mastopexy

I think it is best to consult your surgeon as to what will be best for you. A physical examination is needed. You did not mention when your surgery was done, but you need to wait until complete healing occurs 8-12 months before any decision is made regarding revision.

Susan Kaweski, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 4 reviews

Breast Surgery Revision

It is unfortunate that you did not get the result you were anticipating. The decision as to whether larger implants will be satisfactory can only be made after a detailed exam. Perhaps a different type of mastopexy would be helpful. Again an exam is necessary to make this determination. Consider a second opinion from another board certified plastic surgeon if you are not comfortable with your current surgeon and I hope you finally get the result you want.

David S. Motoki, MD
Draper Plastic Surgeon
5.0 out of 5 stars 16 reviews

Mastopexy and augmentation revision?

Your complaint points out the difficulty in combining breast implants with breast uplift after pregnancies or weight changes.  Keep in mind that the larger the implant, the heavier and wider it becomes resulting in more tension and stretching and thinning of your breast tissue and skin that can occur unpredictably.  You need to discuss your options with a board-certified plastic surgeon but keep in mind that the larger the implant the more likely it is to settle in the future.
Best wishes.
Jon A Perlman M.D., FACS
Diplomate, American Board of Plastic Surgery
Member, American Society for Aesthetic Plastic Surgery (ASAPS)
Beverly Hills, California

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews


It's important to seek revision breast specialist In your area. A revision breast lift may be needed as well 

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 42 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.