Should I Replace my Silicone Implants?

I have had 2 breast augmentations in past. 325cc saline submuscular than 5 years later 425 silicones submuscular due to implant rupture on right side. I have lost size on right side by almost a cup size. Mammogram shows no leakage. I know women loose breast tissue as we age but is this amount normal? I don’t want HUGE breast but have been disappointed both times with size results. Dr. recommends removing and placing in front. Would going 650 cc be too much weight in front?

Doctor Answers 6

Very difficult to tell without examining.

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This is difficult to assess without examining your unique situation. I would recommend consulting in person with a plastic surgeon who specializes in breast procedures.

Breast Implant replacement and size

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Without a physical exam, it would be difficult to say what size breast implant would be in your best interest.  When you obtain a consultation ask to see the various sizes of breast implants that you are considering along with the size that you presently have.  If you are in doubt get a second opinion from a board certified plastic surgeon.  Best wishes.

Implant choices

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If you have concerns where you may want new implants, it is always best to go for a consultation to be properly evaluated. It is impossible to suggest the right implant for you in this forum.

Should I Replace my Silicone Implants?

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Thanks for your question. There are a few things that are not clear to me. One is whether you have also lost volume on the left side. Another is the surgeon will be replacing open implants or just the right one. A third is why surgeon has recommended removing the implants from submuscular to subglandular.  A little more explanation and a photograph attached to your question would be helpful.

In terms of choosing an implant size you must be well aware of the frustration of that process having twice been disappointed with the size. As hard as we try to communicate with her patient's this is often difficult. For new patient with no implants I like to have my patients try implants on using a procedure stretchable material to get an approximate idea of what the size with look like on her chest. 

this doesn't work her patient's already have implants in wish larger or smaller size. However I have found useful the "rice test". I asked the patient to fill a stocking with raw rice kernels, and to contour them around the breast and then place a larger sports bra and then to measure the amount of rice and took to get to a desirable size. with that information your surgeon will have one more item to consider when helping he chews implant size.

Good luck and best wishes.


Jourdan Gottlieb, MD
Seattle Plastic Surgeon

Best Breast Implants for Revisionary Breast Surgery?

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Thank you for the question.

Although it is not possible to give you precise advice about the  best breast implant size/profile that will meet your goals I hope some general guidelines will be helpful to you:

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're 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 if communication will be critical in determining which operation and/or 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 “huge” 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.

By the way, there is nothing in your description that helps me understand why your plastic surgeon is recommending a change in breast implant pocket positioning. You would do well in researching the pros/cons of breast implants placed in the sub muscular ( dual plane) is versus sub glandular position.

I hope this helps.

Replace Silicone Implants?

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It is important for you to have a consultation with a board-certified plastic surgeon to get any meaningful answer, and you can always get more than one consult to make sure you are happy with your surgeon and the recommendations.  From the limited information provided, I would question why you should change to a subglandular position as I don't see any indication for that in your situation.  Best wishes!

Brian Howard, MD (retired)
Alpharetta Plastic Surgeon

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.