Switching from 17 yr old saline 400cc to 550cc silicone hp implants. Can these still somewhat look natural if going that big?

Sometimes the rippling can be best addressed by adding the surface area and projection that you are talking about.  If you have a stretched out pocket and you want to fill it up, you need to go larger.  This increase will give you a modest increase in breast size.  A smaller increase will probably not fix your problem.

It is very difficult to determine the exact size and shape implant you will require during an implant exchange to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 350 cc implant to make her go from a “A” cup to a “C” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link.

Thank you for your question. The high-profile silicone implant has close to the same projection as a moderate saline implant. One of the benefits of the silicone implant is that it will actually give you a more natural looking breast. Silicone implants will also have slightly less rippling then the saline implants. For most of my patients when switching from saline to silicone implants I recommend the high-profile silicone. I believe you will be very happy with your end result. Best of luck with your surgery.

If you are in doubt, you could consider a moderate plus, though many find the HP implant a natural look for them. If the pocket is large and the implants you have move perhaps too freely, a repair of the capsule might keep the implants better centered in the breast.

Thank you for your question.  Yes, switching to HP silicone implants can still look natural if you are currently lacking volume in the upper portion of your breasts.  Silicone tends to sit lower and look more natural anyway, so this does not seem unreasonable.  When in doubt, seek another in person consultation with a Board Certified Plastic Surgeon who performs a lot of revision breast surgery.  Best of luck to you

For a pure implant exchange without altering the capsule or putting in implants that are too big for the capsule space, the recovery is mainly healing the access incision which is hopefully in the inframammary crease and is not like a first time augmentation procedure recovery.Starting with a volume of implant and working backwards is just as bad with re-augmentation as with a first time procedure. It all depends on the dimensions of your breast and the dimensions of your existing capsule relative to the implant present. In general, in the absence of capsule contracture, the capsule tends to stretch over time even if the implant stays the same. Usually a less than high profile implant can be exchanged for a higher profile implant and gain at least 1/2 cup in apparent size without creating problems. Usually the capsule has also stretched from medial to lateral too and a wider implant can be placed which can also make the breast look bigger by about 1/2 cup size. Often both can be done without overfilling the existing capsule and requiring capsule expansion work. Experience and examination of the existing capsule relative to the existing implant is critical. Choosing an implant volume and working backwards is not the best approach.