Revision from 450cc HP silicone to 550cc HP silicone. Would it be noticeable at all? Is 550cc too big? (Photo)

Question

35 yrs old, 5'4", 138lbs, very athletic. I had 2 children and breast fed. I went down to an A cup from breast feeding. I currently have 450cc hp silicone (a year and half now) and am looking to go to 550cc hp silicone. Would it be noticeable enough/ worth having surgery? I am looking for fullness. Are 550cc implants too big for being athletic? What is the recovery time for a revision like so? I attached a picture of a bra from Victoria Secret Perfect Shape. That is what I want them to look like.

Stephen Bresnick, MD · Answer

Thank you for your question about breast revision.  If you increase your breast implant size from 450 HP to 550 HP, the main thing that will increase is the breast width.  Although you will have more upper pole fullness for some time, if you have soft breasts without capsular contracture, the extra upper pole fullness that you initially enjoy will likely settle over time.  In the end, you will be fuller, but likely not higher.  You will be wider and likely have a smaller space between the breasts.  Your breasts will have more outer breast fullness.    Doing a revision is not worth it for some patients because of the risk of capsular contracture.  You really have to think about how important that size increase will be because you appear to have nice results now.   Best wishes!

Andrew Wolfe, MD · Answer

I consider a 100cc increase in implant size to be the minimum difference necessary to actually notice a difference, but it will be a subtle change. In my experience, it is very common for patients undergoing implant exchange to be underwhelmed by what they see postoperatively.  There are sizing inserts that can help illustrate what different increases would look like, though the process is somewhat crude.  If you were lucky enough to have Vectra or other 3-D imaging done before your current implants were placed, those images can be used to illustrate what other implants, be they 550, 600, etc, would look like on you now.  Recovery is often much easier than your original augmentation, although that can vary based on any fine-tuning of the implant pocket that may be indicated.  As for an opinion on whether the 550's can still be considered "athletic", that's hard to judge in photos and ultimately comes down to your aesthetic goals.  Best of luck with your decision.

George Volpe, MD · Answer

To go from 450 mL to 550 mL will in most cases result in a visible change. It is not a huge change but it should be visible. Often, more dramatic changes can be seen at about 150 or 200 mL above the previous size. Do remember however with larger implants there are possible downsides including a heavier weight and possibly other issues. Usually recovery following breast implant exchange has less discomfort than the first time. That does not mean that it takes less time for things to settle. One must be patient.

Amy Simon, MD, FACS · Answer

Ultimately,
only you can decide whether a certain size is right for you.  Often the
best way to determine this is a complete consult with your board-certified
plastic surgeon, including trying on implants in a bra in the office. 
Unfortunately, it is impossible to compare a picture of any patient with a
picture of any other patient, model, or photo from an ad or magazine in order
to approximate the necessary implant size and surgery as each patient’s anatomy
is completely different.  Also, patients who are more athletic sometimes
do not prefer implants that are as large as 550 cc due to difficulties with
their athletic activities related to having larger implants and therefore,
larger breast size; however, this is ultimately a matter of personal
preference.  Hopefully this is helpful and best of luck to you!

John Dean, MD · Answer

It takes about 100cc change in implant size to have a noticeable change.  Your results look good now. If you are happy with your result, but just want a little more fullness, then what is proposed would likely do that.  Am implant exchange would be substantially easier to recover from compared to your initial surgery, as your pocket creation.and muscle stretching has already occurred.

Robert Whitfield, MD · Answer

I now get virtually every patient having breast surgery in my practice imaged using 3D imaging to help with cases such as your case.  If you had imaging it is simple to evaluate potential results.  If not then your preop photos maybe able to be used.

Tom J. Pousti, MD · Answer

Thank you for the question. Keep in mind as you are thinking about your goals that sometimes adjustment of the breast implant pockets (capsule adjustments) may be necessary to achieve the outcome you are looking for.

Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery 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 "noticeable” or "D or DD cup" 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 chosen plastic surgeon to work with you in determining the best plan to achieve your goals.

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

Ciro Adamo, PhD, MD · Answer

Being honest, I can barely see the difference in look between the two bras, which is probably a good thing, since an increase of only 100cc is not going to give you a very visible difference. Without an examination it is not possible to say if 550cc implants could be too big for your frame, but, as a wild guess from a distance, you should be able to have them (and possibly something a bit bigger too, if you wanted a more visible difference).

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