Implant replacement after 12 years, advice on size/shape. Slim, 130lbs 5'8", went at the time from a 32A/B to 32DD (UK) (Photo)

260cc placed over muscle, areolae incision. Very natural looking after a year extremely pleased with them, one started capsular constriction after 9y suspected from nipple piercings now removed. My surgeon advised removal through crease, wait 3mths then sub-pectoral implants through same incision. No discussion yet on size/shape, is the waiting time a common? My worry is more severe or worse scars using the incision twice + 2 ops & assoc. risks. I want larger breasts now, pictures enclosed

Doctor Answers 4

Managing capsular contracure

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Your surgeon's advice is conservative, but sound. The scar is removed when the incision is used, so there shouldn't be any increased risk of poor scarring based upon a staged (two surgery approach). In my opinion your photos show a nice size and shape for your frame. Going larger will result in more "side boob". If you're looking to be more voluptuous you may want to consider a similar (or slightly larger) implant with a higher profile. Best of luck, Dr. Meghan Nadeau, Seattle, WA

Seattle Plastic Surgeon

No Size Guarantee After Breast Revision

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Breast revision surgery is more difficult, complicated, and requires more time than primary surgery. There is as much as a 40% chance additional surgery will be needed following the #revision. As far as sizing, there are no promise or guarantee of the specific cup/bra #size and shape you will be after your surgery.  Implants which are under the muscle or are placed in a new position under the muscle may change with shape on muscle contracture and may have “#banding” and motion of the implants with muscle contracture. If this is unsatisfactory, it may require additional surgery which will also require additional surgeon’s fees, operating room and anesthetic fees.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 116 reviews

How to choose your breast implants.

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Hello Gemma,It is usually possible to remove the capsular contracture and replace the implants in one operation, rather than having two, and so I would advise that you seek other opinions to get a feel for the pros and cons of doing it in one operation or two, to allow you to make an informed decision on what may be the best for you.In terms of the size and shape of the implants that you have, you may like to come along to my webinar on Monday night at 7:30pm where I go through what is involved in choosing the right breast implant and you will see that it is difficult to give you an answer online without talking to you and examining you.It looks like you have a nice result and your goals seem realistic, so good luck.

Implant replacement after 12 years, advice on size/shape.

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Thank you for the question and pictures. You will find that online consultants will not be able to provide you with specific advice in regards to selection of specific breast implant size/profile.  

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

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.