600CC Silicone Exchange for 450CC Saline and Lift, is This Large Enough for a E Cup? 5'4'', 113, 40yr Old? (photo)

Hello,

Keep in mind that although 600 cc sounds like a big increase, and it really is if you are starting with no implants, but it is only 150 cc more than your current 450's, or a 33% increase. This is probably not an "E" cup, but more importantly it is not a big jump, the kind I think you are wanting.  A more appropriate increase would be 50%, or around 675 cc to 700 cc.  Please keep in mind that this is based on very little information and no direct physical exam, and it is possible that my recommendation would be different with an in person consultation.

Additionally, there is more information that I would want you to know before going forward with large volume re-augmentation.  Most of it is obvious, but you should know that large implants exert a higher stress load on your tissues, possibly necessitating more frequent revisions to reposition implants/tighten the implant pockets, or to re-line the walls of the pockets with a product like Strattice, to minimize rippling and reinforce the pockets.  These can be expensive surgeries, and you are most likely going to shoulder the burden of the cost, so think of revisions as an expected cost of having extra large implants (anything bigger than 500 cc).  Also know that your first revision surgery will likely occur before 10 years.

Please be sure that your surgeon is expert in complex revision surgeries, and not just an 'implant surgeon'; this is a very different surgery than your first one, and carries with it more risk, even in the best of hands.  Having said that, implant replacement surgery combined with a breast lift is a common surgery for breast surgery experts, and you're likely to have a great result!

Best of luck!

Having a breast lift done with large implants can lead to problems down the road such as additional sagging and thinning of the skin.  I personally would not advise going that large. Good luck!

Unfortunately, the photograph does not provided any information about breast ptosis and you have not describe whether your implants are in front or behind the muscle.  From your history, it appears that the weight of 450 cc implants have caused descend requiring a lift.  Adding additional weight will cause more descent and may not last the ten years you desire.  You may benefit from a new technique called Implant Exchange with Mini Ultimate Breast Lift.  Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage.  Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal size implant.  Small silicone gel implants placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision.  This may be the best alternative for you to achieve the anterior projection desired without using a larger implant that will descend and require revision.

 

Best Wishes,

 

Gary Horndeski, M.D.

     I typically recommend 100 cc to 150 cc increase to notice a difference in size, so this may be reasonable.  Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast lifts each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

Kenneth Hughes, MD Los Angeles, CA

They do work reliably well and will provide you the information you seek.  High profile implants do place more stresses on your tissue so down the road, you could be looking at have a re-do lift and maybe even downsizing.  Even though we anticipate great long term results, that is never assured so be cautious in what you are wanting, unless you already have significant droop.