Breast revision - would it be worth upgrading from 200cc to 250cc?

Dear AnnaT005,
breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient. When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

You would notice the 50 cc addition to your breasts and it might look very nice on you. Please discuss this with your surgeon. However, you will need to wait until you are 6 months from surgery before doing a second procedure.

Dear Anna,
Your story is historically not uncommon. Many women following breast augmentation 2 or 3 decades ago would wish that they had gone a little bit larger. Today, we have newer technologies and methods of measuring body and breast characteristics, as well as, a much greater array of implant sizes and shapes, that make this scenario much less common. Your surgery was very recent and your breast implants are still settling, so you might want to wait 6 months for that process to complete itself before making your decision. Keep in mind that every time you go back in to your breasts (surgically) you are creating some damage and burning a little bit of a bridge that you might need later. Only you can decide if the 50cc is worth it. Good luck!

To make an accurate assessment regarding the outcome of a plastic surgery procedure we generally need to see a complete set of proper before and after pictures.
There are three variables that determine quality breast augmentation outcomes.
The first is the patient’s candidacy for the procedure. The second is the choice of implants in regards to size, shape, and type.
The third is the surgeons ability to place the implant in the anatomically correct position.
Implant selection is very important and different plastic surgeons very in the ability to guide patients through this process successfully.
It’s not uncommon for patients to wish they were a little braver or chose a larger implant after the procedure.
My personal preference with implant selection is to communicate using before and after pictures.
I typically have a patience select images of what they currently look like, and what they would like their outcome to look like based on previous patients, who have very similar body characteristics.
I use temporary sizers during surgery to determine what size implant will create the outcome. The patient has chosen I bring wish pictures or the selected before and after pictures with me to surgery and use those as a guide together with the temporary sizers to select the right implant.
I have a full selection of implants available during surgery to choose from And I found this is the most useful way to accurately select implants consistent with what the patient wishes are.
Different providers have different ways of guiding patients through this process.
Some providers ask patients to choose implant size. Some providers will have patients put implants in their bra to judge what size implants they should pick. I find this last method to be particularly imprecise.
Increasing your breast volume by 50 mL is only adding 25% to your current implant which according to you is insufficient.
25% increase in implant size is very modest.
I think it would be inappropriate for us to tell you what implant size to choose.
This is something that you should be getting help with from your provider.
In my opinion, it’s never a bad idea to get an in person second opinion for primary procedures or revision surgery.
In fact, I typically recommend patients have multiple consultations before scheduling surgery.
Having multiple consultations allows you to choose the better provider for your needs.
By selecting only one consultation and then scheduling surgery patients completely eliminate the ability to choose the better provider.
Plastic surgeons, very in their ability to perform this procedure and guide patience through implant selection.
My best guess is most plastic surgeons would probably say adding only 50 mL of of volume is probably not enough to justify having a second operation.
These are very individual decisions and cannot be made without context. A 200 cc implant may be quite substantial in size on a very petite person, but may not show much change at all for a woman who is on the larger size.
Follow up with your provider or schedule in person second opinion consultations with other plastic surgeons in your community.
Best,
Matt Hagstrom, MD