Would 600cc be too big on my frame? HP or mod+? (Photos)

Question

I'm getting a 2nd BA in a couple weeks. Right now I have 375cc(left) and 425cc(right) mentor smooth round HP. I lack volume, fullness and upper pole even though I have HP. My breasts sit naturally without a bra and they sit low when I wear a bikini. When I lay down, my implants fall over to my armpits. I think my pockets were made too big? Would 600cc(left) and 650cc(right) achieve the look I'm going for or would it be too top heavy on my frame? HP of Mod+? I'm 23, 5'3, 125 lbs, no kids.

Steven J. Rottman, MD, FACS · Answer

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.
  
The size of implant is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.
  
Silicone will give you a fullness at the top (upper pole fullness).
  
Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.
  
Anatomic gummy bear implants might be a good choice to give you volume.
  
These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.
  
During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.
  
The best way to assess and give true advice would be an in-person exam.
  
Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.
  
Best of luck!
  
Dr. Schwartz
  
Board Certified Plastic Surgeon
  
#RealSelf100Surgeon
  
#RealSelfCORESurgeon

Curtis Wong, MD · Answer

and going larger may help you but if your lateral pocket is too generous, your implants will still slide into your armpits when on your back if the width is not enough to take up the space in your pocket.  Adding a 200+ sizer using an unlined bra would help you better visualize what you will look like and if that is 'top heavy'.  Make sure you will get all of your concerns addressed with your revision so you are are not disappointed after your upcoming procedure.

Tom J. Pousti, MD · Answer

Thank you for the question.    Keep in mind as you are thinking about your goals that sometimes adjustment of the breast implant pockets (capsule adjustments) may be necessary to achieve the outcome you are looking for.  Ultimately, careful selection of plastic surgeon and  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, in bra sizers, and computer imaging) as well as careful measurements (dimensional planning) will be critical.
 Generally speaking, the best online advice I can give to ladies who are considering breast augmentation revision 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. For example, I have found that the use of words such as "C or D cup" or "top heavy" 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.
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.
I hope this (and the attached link, dedicated to breast augmentation revision surgery concerns) helps. Best wishes for an outcome that you will be very pleased with.

Tim Sayed, MD, MBA, FACS · Answer

Thanks for your question. Have you already decided on a surgeon or are you genuinely interested in other surgeons' thoughts? An in-person exam would be VITAL to assessing your current implant to pocket ratio, your skin stretch, the level of "overhang" (ptosis) of the breasts, etc. These can't be fully assessed based on photos alone. We routinely replace implants and many of our patients look to upsize to a larger volume based on stretching of a prior pocket, differences in implant styles, etc. Please let us know if you are interested in more information. Otherwise, if you have made your decision on a surgeon, please be sure that individual is board certified by the American Board of Plastic Surgery and that you have asked and had satisfactory answers to your questions in person. Hope this helps!

Milind K. Ambe, MD · Answer

Thank you for your question and photos.  Your tissues already appear to be a little tight with the implant size you have.  If you go up to 600/650cc implants then your result will not look as natural as the image you desire.  Yours would look more high and tight/round on top.  For definitive answers I would see Board certified plastic surgeons you perform a lot of revision breast surgery.  Your situation really requires an exam for best analysis.  Best of luck to you

Frederic H. Corbin, MD (license restricted) · Answer

Thank you for the question and size is an individual decision based on measurements so your surgeon can choose the best shaped implant for you at the desired volume.Dr Corbin

Would 600cc be too big on my frame? HP or mod+? (Photos)

Answers (7)

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