What to Do when PS Went Bigger Than I Asked with Breast Implants?

I am 29 and underwent a primary breast augmentation on 4/13/10. The first thing that my PS said to me when I came out from surgery is, "I used 400cc." During preoperative we had discussed using 300-325cc. When I asked him why he had used that size he said that when he sat me up they fit my body better. I started off a 34A/32B (5'3", 105 pounds)and had desired a 32C. Now I am afraid that I will be bigger than I had desired (I'm a yoga instructor, I can't be big). Transaxillary, subglandular, 400cc, memory moderate-plus. What now?

Doctor Answers 11

Implant size larger than expected.

Choosing breast implant size is a collaboration between you and your surgeon.  Some patients come in with a specific size request.  Others are more comfortable with the surgeon recommending a size.  I try to work with patients either way to come to an agreement about a size or in some cases, a range of sizes that we will work.  If a patient is comfortable with me recommending a certain size, then I will do so.  This is done with a combination of asking what the patient's goals are, what their body frame is, and the original size and dimensions of their breasts.  It is not uncommon for patients to be a bit surprised at first because the change is immediate and noticeable.  I find that nearly all patients are satisfied with their implants after about a month or so.  I would encourage you to give this a few months both for the swelling to go down and to get used to the body change.  If you are still concerned, then you should speak to your surgeon about possible solutions.

Seattle Plastic Surgeon
5.0 out of 5 stars 12 reviews

Breast implants larger than expected

First, wait a few weeks for your swelling to go down, and then asses your size.  Immediately after surgery, your breasts will appear 1/2 cup size larger secondary to swelling.  If you feel that your breasts are still too large after that point, speak to your surgeon about your concerns.  An exchange could be done to reduce the size of your implants, but this is something you and your surgeon would need to discuss in detail, especially if he felt that the smaller implants were not appropriate at the time of the initial surgery.  Good luck, /nsn.

Choosing the right size needs to be a collaboration

It is early in the healing process. Allow yourself 6 months to heal and then assess. Based on your assessment and healing, reoperation is possible between 6 - 12 months.

The size decision especially for primary breast augmentation needs to be a collaboration between the patient based on her needs/objectives and the surgeon based on his or her experience/expertise.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.5 out of 5 stars 36 reviews

What to Do when PS Went Bigger Than I Asked with Breast Implants?

What to Do when PS Went Bigger Than I Asked with Breast Implants? Take a look at your chest. You will be, on avearge 10-15% smaller in 6-9 months. If this is bearable, then wait for the swelling to resolve..  If this is unacceptable to you, ask your surgeon to replace them sooner.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 72 reviews

Breast implant size

Now, you have to give it time to heal and settle down. There will be a lot of swelling and waiting 6 months or longer will give you a better idea of how they will look long term.

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

Breast implant's too large?

Wait.  Give it at least 6 to 12 months.   Mention to him/her that you are concerned but willing to wait.  If you are still unhappy after that time period, discuss it with your surgeon.  Most reputable surgeons will make every effort to see that you are pleased with your result.

Kevin F. Hagan, MD
Nashville Plastic Surgeon
4.8 out of 5 stars 4 reviews

Who CHOSES the Breast Implant

It sounds like major miscommunication. I agree with most of my colleagues that now is NOT the time to contemplate any immediate return to the OR. The best course is to wait for a few months and see if you are happy with the results before kicking up sand and revising your breasts.
The following are MY opinions on the topic of WHO CHOOSES the size of the breast implants:
- My role is to educate my patients on the plusses and minusses of Breast Augmentation surgery. Every decision has its benefits and shortcomings; Location of incision, location of implant pocket (over/under the muscle), implant shell type (smooth / textured, LP, MP, MP+ or High profile, HP, round vs Anatomical etc), saline VS gel, and finally Implant volume
- The only person carrying these implants will be my patient. Therefore, SHE not me has to have the final word on implant choice. If as a Plastic surgeon I feel that the implants are bigger than what I would have chosen I make her aware of it. If the implants are monstrously too large or rarely too small, I always have the option of declining to operate on that pt. But is is THE PATIENT'S ULTIMATE RIGHT TO DECIDE and choose her implants and no one else's.
Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 102 reviews

How to pick breast implant sizes.

Sounds like bad communication.

1) This is the most common type of question on RealSelf.

2) It is the surgeon's job to pick the right breast implants, not the patient's. Implant selection is really pretty technical.

3) Make sure your surgeon REALLY understands the look you want. Mentioning a cup size is not enough. Show your surgeon pictures of breasts you like.

4) Then your surgeon has to tell you if your chosen look is realistic for your anatomy. The most common mistake is to go too big.

5) I recommend that the surgeon NOT make a final implant choice in advance, because this is just an educated guess.

6) The surgeon should have a large inventory of different size and shape implants available in the operating room.

7) Then the surgeon can put sterile disposable implant SIZERS in your breasts during surgery, to see what a particular implant really looks like inside you. This is how to make the best choice. A sizer costs only $45, and takes all the guess work out.

8) Finally, the sizer is discarded, and the correct breast implants (based on what you want and on your anatomy) are opened from the operating roon inventory, and put in your breasts to complete the operation.

Web reference: http://www.drberaka.com/proc_performed/breast_aug_surgery.html

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Too early to discuss the isze

I would suggest that you wait at least 3 months. You had enough trust in your doctor that you let him operate on you, now you need to trust his judgment and wait till the swelling is resolved. If you think your breast are too big after the healing period, then you can sit down with your doctor and discuss the replacement.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 113 reviews

Breast implants too big after surgery

As Dr. Naidu said, you need to wait 3-4 months until all swelling is gone and you really know what the result is going to be.  At that point you might be just fine and very happy.  If they are still to large, you should discuss options with your surgeon and find out about downsizing and why exactly they changed the plan during surgery. 

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.