110 lbs 5'2" breast implant revision #2. Contemplating Inspira srm 330 or srf 345. Dr wants me to pick size. (photos)

circa 1980 ruptured, replaced with421cc style 15 (2015) and anchor lift (1) revision lower pocket ( 4-2016) 1st revision Doctor lowered both pockets and reused the same implants. My non existent medical degree is causing me stress. A smaller diameter I am hoping will not push up the armpit fat, raise the nipple and give a rounder appearance ? Pictures are current I am measuring 32 ddd . I am wanting prortionate and not matronly

Doctor Answers 6

Multiple Revisions

Hello,

Make sure your doctor is an ABPS certified/ASAPS member surgeon that specializes in revision surgery. You appear to have implant malposition and possibly capsular contracture in one or both of your breasts. Best of luck!


Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Which implants should I choose

Hi and  thank you for the question. A couple of thoughts come to mind. First of all, there is very little difference in the implants you are discussing. The volume difference is negligible. The high-profile implant will certainly be a bit narrower and a bit taller, but not by much.  I think what is far more important in your case is the surgeon dealing with the distortion you have from the capsular contracture. 

 I am not in favor of asking patients to pick what implant they want. What makes more sense to me is to have a patient describe what they want, then let the surgeon figure out how to deliver that kind of result. My suggestion would be to find another surgeon or two to consult with.  The way I would handle your case would be to bring several implant choices to the operating room. I would remove your existing implants as well as the scar tissue. I would then sit the operating table up and see what you look like with several different implant choices. I would then pick the implants that gives the result that is closest to the goals that you have shared. This is why it is very important to let your surgeon know exactly what you want. Providing photos of the type of results you're looking for can be very helpful. Good luck to you.

Dr West


Justin West, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 25 reviews

Revising the revision

Thanks for your question and the photos. I agree that you will be better off with less volume which seems to be mainly seen in the upper pole. Less volume and less projection will help. If the pocket is not altered (lowered) then the nipple position won't really change regardless of implant used (330 vs 345CC) Best of Luck!

M. Scott Haydon, MD
Austin Plastic Surgeon
4.9 out of 5 stars 84 reviews

SRM versus SRF

Thanks for your question! I really don't like to go into a surgery with only one size implant in mind; I favor more of a range. We sit out patients up during surgery, and always use sizers. In the hundreds of implant surgeries that I perform per year, & thousands in my career, that has served me well. 

That being said, I think I'd go with the M's: you have a lot of projection, & I think a moderate profile & slightly smaller implant like the 330's would work well for you. I'd also do a supra areolar crescentic mastopexy. Best of luck to you!

Robert P. Schmid, MD
Lubbock Plastic Surgeon
4.9 out of 5 stars 31 reviews

Best breast implants for me (revisionary breast surgery)?

Thank you for the question. Online consultants will not be able to provide you with specific enough advice to be truly helpful. 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, patients undergoing revisionary breast surgery should understand that there may be many variables besides breast implant volume that come into play when determining optimal  breast implant selection during revisionary breast surgery.  For example,  , adjustment of the breast implant capsules may be necessary; this adjustment may be a factor when it comes to selection of appropriate breast implant size/profile.    Lots to factors to consider...



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. For example, I have found that the use of words such as “proportionate, not matronly” or "DDD cup” etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.



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.  Personally, I find it most beneficial to have a wide range of breast implant types, sizes, and profiles available.


 In your case, given that your plastic surgeon wants you to make the decision, I would advise that you spend as much time as necessary seeking his/her advice ( after careful communication goals).


I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes for an outcome that you will be very pleased with. 

Challenging breast implant revision

Thank you for your question.  Breast implant revision can pose several challenges.  Your photos demonstrate asymmetry, possible capsular contracture and large implants for your frame.  Going with smaller implants seems to be the right thing to do.  Adjusting nipple position may require a mastopexy, especially since you already have an anchor scar.  Several other considerations may be required including deciding implant size - this really requires an in person exam to clarify and decide.  Good luck.

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 16 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.