Breast tissue expanders to implant exchange surgery. Does the same size give the same results?

The final appearance of your implants may be different from the appearance of the tissue expanders.  In my experience, a round implant of approximately the same volume as the tissue expander will often look smaller than the expander looked.  A shaped implant of the same dimensions (width, height, projection, and volume) as your expander will probably look about the same as the expander.  As others have mentioned, depending on the implant your surgeon is planning to use, they may decide to overfill or underfill the expander to create a pocket of the best dimensions for that particular type of implant.  Since you like the look you have at this point, talk to your doctor about your preference and discuss their recommendations about how to proceed with regard to further expansion and implant type to try to achieve that look.

If you are happy with the current look then most likely you don't need to go any bigger and you are ready for your next surgery.There are two issues really.  Firstly volume, secondly shape.  If you are happy with both I suggest simply exchanging to your definitive implant.  Your expander will dictate this somewhat and without knowing the specifics it's hard to guess if high profile or moderate plus profile implants will be better.  The other decision is round or anatomical implants.  I suggest you consult with your plastic surgeon in person and go over these decisions with them.All the best,Dean

Typically expanders are overinflated in preparation for an implant exchange, sometimes 10-20%.  This allows enough laxity in the pocket to properly place the implant.  Expanders and implants fill the pocket differently, and it's difficult to predict exactly which implant will fill the pocket best.  Thus,  in most cases different implant sizers will be placed in the breast during surgery and the best fit will be chosen.  Best of luck,Keith M. Blechman, MDNew York, NY

It depends on if you are going with round or shaped implants. If shaped, I plan on underfilling by about 30-50 cc that way the new implant fits snugly in its pocket. 

If round, then expanding a little past where you want to be, is advised in most cases, or at least to the same volume.  If you're happy with that size though you should have a great result and communicate with your PS. The real implants will look even better and feel so much better than the expanders

I will often overinflate the expanders after I get to the volume the patient desires. I will then go back in and place implants at the volume preferred.

Thank you for the question.





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. 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 "B or C cup" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.



Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to guide you or 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.







I hope this (and the attached link, dedicated to breast augmentation surgery concerns) helps. Best wishes.