HPG 300cc silicone 1 year ago: I asked for size C, now I got size D. Right breast has ruptured I need size C or B.

Question

I am 5'8 140 and my shoulder it is very wide r ( I always hate having big breast ) unfortunately I got bad experience with Dr ( he suggest foe me to use high profile gel 300cc silicone from day one I mention this is too big for me they keep saying will be smaller in future and then I found out my right side its not normal which is I found out its RAPTURE and I need to remove and change it, how can I find to put & have cup C or less how many more size less can I use so I can have cup C

Gerald Minniti, MD, FACS · Answer

Hello,No surgeon knows how to achieve a particular cup size.  That is because there is no equation that relates bra cups to implant volume.  Remove these HP implants and get an implant of equal diameter but lower profile. If your implant is ruptured, it was likely injured at the time of surgery; this can be determined when the implant is returned for inspection by the manufacturer, something that is necessary if they are to honor their warranty. Best of luck!

Urmen Desai, MD, MPH, FACS · Answer

The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Daniel Barrett, MD · Answer

Dear shahla shafli,determining the ideal breast size and matching that goal for the patient is the most difficult part of breast augmentation. It starts and ends with the patient. We have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements. Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If its too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match. Of all of my breast augmentation patients, everyone of them have been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast surgery.  My best advice: stop focusing on achieving a specific cup size.  In my practice, I ask my patients to not refer to cup sizes, when it comes to communicating goals or evaluating the outcome of the procedure performed. There is simply too much variability among bra manufacturers (or personnel doing the measuring) to make use of cup sizes helpful whatsoever as a reference point or form of communication. Furthermore, there is no accurate/reliable/predictable correlation between size/profile breast implant utilized and cup size achieved. For example, I do not think that the generalizations of "200 cc equates to 1 cup" hold any validity or are helpful in any specific or practical way.  Instead, communicate your goals carefully (goal photographs are helpful in my practice) and make sure that you and your plastic surgeon are on the same page prior to proceeding.  Best wishes.

Arian Mowlavi, MD, FACS (license on probation) · Answer

First of all, not sure why your doctor recommended high profile; high profile is not always better ! The style depends on you breast dimensions and goals. If you want to go down by a size, I would reduce breast implant size by at least 100 to 150. Also have you considered the Ideal Implant? A consultation with a board certified plastic surgeon should really help you figure out what will be best for you. Finally, need to get breasts fixed ASAP so that one side does not collapse and tighten more than the other.

Jon A. Perlman, MD (retired) · Answer

I'm sorry to hear of your unpleasant experience.  At the outset I must point out it's highly unusual for silicone implants to rupture in the first year and I'd like additional information to discover what the cause was.

It's very difficult as a surgeon to equate a certain volume with a cup size with accuracy so it's in your best interest to show photographs of breasts you feel are achievable and represent your size goal to assist your surgeon.  During the surgical procedure test implants called sizers can be placed with you positioned in a semi-upright position to allow for the best choice of the permanent implant.  This adds some extra time to the procedure but I feel is more accurate than simply guessing an implant size based on how it feels inside your bra or based entirely on measurements.

It might be in your best interest to seek a second opinion from another local ABPS board-certified plastic surgeon to give you a sense of confidence in your final decision.  Best wishes for good result,
Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)Beverly Hills, California

HPG 300cc silicone 1 year ago: I asked for size C, now I got size D. Right breast has ruptured I need size C or B.

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