Will going bigger achieve my goal? (Photos)

I got saline implant (330cc) above the muscle, now I feel that 3 months later I still don't have my volume back that I originally wanted. If you see my last post there are pics from before surgery. Did I go too small? I loved the swelling right after for about a month because they were round and full. In the pic with my white shirt was 10 days after surgery. Is it possible if I go bigger can I achieve that look permanently? I want more volume on top and I'm kind of disappointed at this point.

Doctor Answers 13

Bigger implants

Implants placed in front of the muscle have only skin to support them, therefore, bigger implants in front of the muscle will only drop. I would recommend larger implants behind the muscle with mod plus or high projection so that you do not need a lift which appears to be the case from your lateral pictures.


Weston Plastic Surgeon
4.0 out of 5 stars 4 reviews

Bigger implants

Thank you for your pictures and question. Breast augmentation patients have extra fullness in the upper poles of their breasts during the 1st 3 months but then the implants drop in the pocket to a more natural position. At that time implant exchange can be done but you must remember that a larger implant is a heavier implant increasing your risk of needing a breast lift in the future. 

Mark Deutsch, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 29 reviews

3 months post op, some advices:

Thanks for the question.

In my practice, after performing a BA I recommend to my patients to limit the movement of the arms for two weeks. After that, you can move your arms taking care and always with common sense.  In this regard, it's not advisable to carry heavy weights to prevent the implant out of position, and allow the formation of the physiological capsule around the implant, also to avoid pain and breast swelling. 

Kind regards

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 177 reviews

Will going bigger achieve my goal?

During your first consultation with the Doctor- a sizing process should have taken place. In our Practice we perform measurements and when indicated simulate the look with a lift. From your photos- in my opinion- a lift would be of major benefit to you and then, 3 months later- put in the implants that you desire. That may seem complicated but in my opinion - it's the best way to achieve your goals

Larger implant for upper pole fullness??

I'm afraid the laws of gravity also exist on your chest. Should you go larger, your results will be even more short lived due to the increased weight of the implants. At this point, it is best to protect your investment by wearing supportive bras to keep further descent. Make certain you also wear supportive undergarments during sleep as the weight of your implants can also displace them laterally (further apart from your cleavage). I recommend you visit the breast augmentation revision forum on this site for more information on the risks and complications associated with large breast implants. Things to consider when using larger implants: skin stretch deformities, chronic pain, nipple numbness, malposition, capsular contractures, irreversible soft tissue damage, etc. I hope this helps. Best wishes and kind regards, 

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.7 out of 5 stars 209 reviews

Will going bigger achieve my goal? (Photos)

I see 4 options: #1 Do nothing. #2 Exchange to larger implants in the 500 cc ranges. #3 Lipo with fat grams to breast. #4 combine #s 3 & 4.

Be sure you are asking the right questions- what you ask for may make you happy in the short term only to compromise your future

Your outcome and dissatisfaction raise several concerns and questions, and I think that to understand what your best course of action might be at this point, it is critical to be as sure as possible that you ask the best questions about not only what your options are now, but how those options might affect your appearance in the longer term.

Considering the difference between your immediate postoperative appearance and your 3 month outcome, you already understand that there is often a difference between what can be achieved in any procedure in the short term and what the longer term implications of that procedure might be. This will be important to your understanding my answer to your question.

I do not believe that at three months you should still have any significant swelling. I think that at the present time, your breasts look as close to your goal as they are going to get (in other words, they will only relax more over time, not become more full and perky).

Having your implants exchanged for larger ones MAY more closely approximate your goals in the short term, but if you were my patient, I would be VERY concerned that achieving your goals in the short term would only (and significantly) increase the odds of your longer term unhappiness. Let me explain- it is important to understand that when implants are placed over the muscle, there is less support for the implant than under the muscle, and this tissue support generally has poorer integrity than when under the muscle as well. Over time, in the vast majority of patients, this means that the breast appearance will become less perky and round as the tissue and skin become stretched as a result of gravity and the weight of the implant. 

This means that (in my opinion) exchanging your implants for larger ones MAY give you what you want in the short term, but as time passes (how long will depend on the qualities of your tissues, skin, and lifestyle) the larger implants will cause even more stretching of the skin and tissues, and more sagging and an appearance further from your goal. 

I would discuss this carefully with your surgeon.

BA revision

You have achieved a very nice natural look. If you want a more augmented look this is absolutely possible, you would need some more volume with a taller profile. 

Implants

I think that your breasts look very nice. You have to realize that you implants are in line with the "foundation" of where your breast are. To try to force them higher up can only be achieved with a  bra. You can cheat a bit with wider/taller implants.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Implant size is not the problem, think anatomic tall instead of round narrow

The aspects of your breasts that you are unhappy with are mostly the result of implant selection.  You have round highly projecting implants which are too narrow to give your the high and wide fullness you deisre.  Switching to a bigger and taller implant like an Allergan 410FM(full hieght moderate projection) anatomically shaped implant would give you the superior pole fullness you are after and allow a much larger volume implant while still appearing natural.  I would also recommend a neo-subfascial or sub capsular placement depending what your intraoperative findings are.  I hope this helps!


All the best,


Rian A. Maercks M.D.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.