What Should my Discussion with my Surgeon Be Like About Replacement of Implants As Far As Size & Appearance Goes?

I am 1 week PO after explantation of 35 yr old ruptured, silicon, in front of muscle implants, with quite alot of tissue & muscle damage. I have very little tissue & they are mishapen. My old ones were 225 cc (size B cup) which I was happy with, but my Dr. says he will need to go larger but won't tell me how much, he says he will go by my body structure, etc. He mention over 400cc's to my sister. I am 67yrs. 5"7" & 145 lb (25 lbs more than 35 yr ago)The replacments will be silicon, under muscle.

Doctor Answers 3

Best Breast Surgery Option for Me After Breast Implant Removal?

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Thank you for the question. Based on your question, I think you would benefit from significantly more time spent with your surgeon discussing your goals,  surgical options, as well as the potential risks/complications associated with each option.

In mu  Practice I ask that patients bring in “goal pictures” of what they would like to achieve. It is also helpful to view pictures of breasts that they feel are too small or too big… Viewing goal pictures without clothing are most helpful.
I have found that the use of words such as “natural”  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.

After direct examination and a full communication of  your goals, it is likely that your plastic surgeon will be able to provide you with some guidelines as to what size/profile/ type of breast implants  will most likely help achieve your goals.  Whether breast lifting would be advisable should also be discussed.

Once you feel you have communicated your goals clearly,   I suggest that you 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.  In my practice, this decision is usually made during surgery.

I hope this helps.

Breast implant size

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Once you are completely healed, and you still want breast implants. You decide what size breast approximately you want. It is utterly unacceptable to accept from the surgeon that he /she would not tell you atleast the range of implants that fit your meaurements of the breast.

The other decision you need to make is where the implant is put, above or below the muscle . The surgeon will advise you what is best for you and why.

Next decision you make is type of implant, Saline, Silicone, or shaped highly cohesive implant, your choice.

Find another surgeon who is willing to sit with you for a consult of one hour expalining all your options and risks and cost. Discuss revision cost and who is responsible for what.

Samir Shureih, MD
Baltimore Plastic Surgeon

Replacement of silicone implants

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First, I would encourage you to heal from the explanation, which sounds like it was rather involved and then assess the sizing or whether you even want to replace the implants rather than have a breast lift alone. I am not sure why your doctor has recommended going larger except to correct sagging and this can be accomplished with a combined augment/lift so I think there is a great deal to discuss.  There should be a comphrensive discussion and you should not go into surgery with absolutely no idea of how large the implants will be.  If you lost a great deal of breast tissue with the explanation and scooping out of the cavities, then larger might be more in the form of replacement of lost breast volume than augmentation per se.  Best of luck.

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.