I have 375cc after first breast augmentation. What is the biggest I can go for in 2nd surgery? (photos)

About a year ago I had BA surgery and from 70AA (just nipples) went to 75C. 375cc, round, silicone, Motiva implant with high profile was the biggest possible surgeon could put during 1st augmentation, but sadly it didn't bring desired results. Next week I have consultation and want to know what size I should ask for. What could be maximal possible cc size this time? I am still interested in round, silicone implants, but want another manufacturer - Allergan, Mentor, Nagor or Polytech.

Doctor Answers 5

Second augmentation

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I agree with the others, you have a constricted lower pole.  It's not realistic to achieve your goal with another augmentation alone.  It be best to place a tissue expander to get to the size we want to achieve  and then put in the permanent implant. You may also need some fat grafting.

Savannah Plastic Surgeon
5.0 out of 5 stars 21 reviews

Bigger implants?

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The main issue in your case is the constricted lower poles as Dr. Gordon stated. As you see from pictures there are bands at the areola border and lack of lower breast expansion. I would recommend fat grafting over the implants for correction of the constriction and enlargement. The wish size is too risky and too many complications due to the over stretching of the breast tissue.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 153 reviews

Biggest possible implants for breast augmentation

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There is a limit to the size implant that will fit into the pocket during a breast augmentation.  From looking at your photos, you may also have a constricted lower pole.  Given a possible constricted lower pole and the wish picture you gave, you would probably best be served with a tissue expander first, followed by a permanent silicone implant.  You need a much bigger implant than a 375cc to get to your wish photo.  The photo you showed looks more like a custom size implant (larger than those offered in the regular implant catalogue).Ultimately, you need to meet with a board certified plastic surgeon and discuss your goals in detail.  A physical exam will help your surgeon give appropriate advice as to what is possible and the best way to get there.

Julian Gordon, MD
Alpharetta Plastic Surgeon

Larger implant size

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I would suggest a consultation with a surgeon that has 3D imaging capability.   You could get an impression of the size and result with different implant sizes and profiles.  Good luck on achieving a good outcome.

What is the biggest I can go for in 2nd breast surgery?

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Thank you for the question and pictures. You will find that online consultants will not be able to provide you with specific advice in regards to selection of specific breast implant size/profile. Having said that, it is generally necessary to utilize high or ultra high-profile silicone gel breast implants or overfilled saline breast implants to achieve the types of outcomes you demonstrate with the goal photograph.  

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. 

Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation 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. I have found that the use of words such as “natural” or "D or DD cup” or "biggest possible" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate. 

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). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient.

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

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.