Not as big as I want to be (Motiva implants). If a year later, everything has dropped, can I get another surgery and go bigger?

Question

When I was at the consultation, we agreed on 380cc. However, I was given a serial number to register my implants at MotivaImagine, and I can see "Vol: 280" I'm guessing I was only given 280cc? I'd have enough space and my frame could fit more, right? Thank you.

Aldo Guerra, MD · Answer

Of course you can! However, you should give your breast implants and your bew breast cup plenty of time to bond with you. Bigger is not alway better or prettier so choose wisely!Best wishes. Dr. Aldo

Ram Kalus, MD, FACS · Answer

There are two separate yet related questions you have posed. The first relates to the surgical plan and a proper pre-operative informed consent with your surgeon. The second relates to your breast appearance and your level of satisfaction. A precise answer to your question regarding upsizing cannot be provided without a physical examination in person, or at least photographs. That said, if your breasts would accommodate a larger implant, revision surgery can certainly be considered. If it was your understanding that you would be receiving 380 cc implants and you received 280 cc implants, it is possible that you did not accurately hear your surgeon's recommendation. If there was a true change in the surgical plan, it is best to discuss your concerns with your surgeon.If you remain convinced that your level of satisfaction is indeed dependent on being made larger, this is something you should also discuss with your surgeon. If you feel less confident with your surgeon you can seek a second opinion. In general, from a surgical standpoint it is best to wait at least three months before considering revision surgery, but from a psychological standpoint I usually recommend waiting 6-12 months since, over time you may find that you have gotten used to you new appearance and breast size and you might find yourself happier with a more conservative augmentation. Best of luck to you.

Daniel Brown, MD, FACS · Answer

Hello and thanks for your questions.  If you had agreed on 380 and 280 were placed, this would be a very good topic to discuss with your surgeon.  If this was a mistake, your surgeon should be able to easily correct this by removing the smaller and inserting larger implants.  Regardless, you should not have to wait a year if going larger in size, and in fact you should be able to have larger implants placed any time after 3-4 months.Best wishes!Dr. Brown

Stefano Cotrufo, MD, PhD, EBOPRAS · Answer

Of course you can consider a different cup size in one year time. Just make sure you will consult with a European Or UK Board plastic surgeon who can quantify exactly how much your tissues (breast, skin etc) can stretch without any damage.

Tom J. Pousti, MD · Answer

Most patients are able to "go larger" at a second stage, once the breast tissues have expanded (after first-time breast augmentation). Sometimes, during this revisionary surgery, adjustment of the breast implant capsules is also necessary to achieve the desired outcome. Exactly how much larger you can achieve during the revisionary breast surgery will depend mainly on your physical examination and goals.
 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 "C or D cup” or "one cup size increase" or "significant or noticeable change" 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 helps. Best wishes.

Steven Wallach, MD · Answer

If after 6 months to a year you find that you want to go larger, you might be able to as the tissues have stretched.  Best of luck.

Ben Gbulie, MD, FACS · Answer

HiThanks for question.You should speak with your PS to confirm what implant size you have and if there was a reason you didn't get larger implants if indeed the ones you got are 280ccs.That being said, your own perception of your result is more important - i.e. if you're happy with the result then don't fixate on the size. You may go bigger after the implants have settled but remember each time you undergo breast surgery there is a risk of complications. So I would only recommend that if you are truly not happy with your end result 6-12 months from the surgery.I hope this helps.....

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