What if my Surgeon Lied to Me? Can You Fill a 465 Saline Implant to 520?

Question

So I recently had the op. Pre op I was 34a I wanted to be a full c or small d. But post op I feel/look like a B cup. I went with 520cc.. I asked on here if I looked like a C cup and withthe pics I provided I was told by many surgeons that everything doesn't add up. It doesn't look right and I don't know what to do. I'm not happy at all. So one the back of the card it says 465cc for right and left and on the front he wrote in 520cc and 480cc. Can you fill a 465 to 520? What do I do if I'm not satisfied

Gerald Minniti, MD, FACS · Answer

Hello Again,

	So, you have Allergan 68HP 465cc saline implants, one filled to 480, the other 520.  The manufacturer's recommended fill is up to 505, but it is not unusual for surgeons to go above or below that number.  As I said when you posted last time with your photos, your breasts look pretty tight, and your tissue may be flattening out your implants.  I believe you will experience more projection as your tissue loosens (3 to 6 months).  You may in fact still be unhappy at that time, but really there is nothing more you can do now but heal.

	Have this conversation with your doctor.  Keep in mind that he has unlikely tried to be dishonest with you (why would he want to anyway?), and that he probably did his best to achieve the results you were both looking for.  Additionally, please understand that breast augmentation is not always straight forward and simple, as there are so many factors that affect your result; that is why it is impossible to predict a bra cup size based on a given implant size.

	I do hope you will be happy in the end!!

Vincent N. Zubowicz, MD · Answer

If your surgeon is legitimate it would be impossible for him to lie about the implants. Saline implants come in specific sizes and you would have been given a card that states the size of the implants in place. The implants can be filled in this would be noted in the operating room flowsheet. If you're in doubt get a copy of your operative record. If you are dissatisfied I'm sure your surgeon will work with you unless you accuse him of lying.

Kenneth Hughes, MD · Answer

The implant probably had a 465 to 505 fill range.  So overfilling to 520 cc is not unreasonable.  Kenneth Hughes, MD Los Angeles, CA

Steven Wallach, MD · Answer

Each saline implant has a recommended fill volume.  Underfilling implants can lead to stress damage to the implant leading to deflation.

Jeffrey Zwiren, MD · Answer

There are specific manufacturer recommendations for the minimum and maximum fill volume for a saline filled implant. In general if the implant is under filled it will crease and if it is overfilled it will ripple. One of the oddities with a saline filled implant is that as you over expand it the base diameter gets smaller meaning the implant gets rounder. There is generally no limit to how much one could overfill an implant but you run the risk if the implant rotating in the pocket. There is a definite front and back to the implant. If the implant flips it will have a different shape. The implant will also be firmer if overfilled as well as rounder. In general most surgeons would agree that a 20% over fill of a saline filled implant is acceptable.

Tom J. Pousti, MD · Answer

I am sorry to hear about your concerns after breast augmentation surgery. Although it is not possible to give you precise advice based on the limited information available, generally speaking the vast majority of surgeons will have no reason to “lie” about your breast implant size/volume. Overfilling the breast implants to 520 mL is not unreasonable.

	 If you are unhappy, I would suggest that you communicate your concerns to your plastic surgeon in a calm/constructive fashion. Hopefully  during this communication process you and your surgeon can come up with a plan to improve your situation, if possible.

	 Best wishes.

David A. Ross, MD (retired) · Answer

Yes, If the base volume of your implant is truly 465cc it is possible to fill them to 480 and 520cc. These sizes characteristically increase any breast by approximately two and one half cup sizes. If your were a real A cup before surgery then your plastic surgeon theoretically chose the correct implants to augment you to a C cup. If you were smaller then an A then these sizes could fall short of your desired goal. I suspect that this latter point is true. It is not that you don't have the stated implants sizes it is just that you actually require larger then 480 and 520 cc to get the job done.

Dennis Dass, MD - Account Suspended · Answer

You have high profile breast implants. The amount filled is reasonable for that implant, because they have a fill range. I know its hard to wait when you're not happy, but it is best to wait for 3-6 months, before you know what the final shape of the breasts are. You should get professionally fitted for a bra to determine the appropriate fit.

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