There are three variables that determine the quality of breast documentation surgery. The first is patient candidacy. The second is the correct selection of implants in regards to type, shape and size. The third is the technical ability of the surgeon to place the implant in the correct anatomic position. Choosing the right implants is an important variable and it’s not uncommon for patients to go into the procedure, wanting a natural appearance and later wish they were more assertive with implant selection. Each plastic surgeon will have their own way of guiding patients through the implant selection process. Using excessively large implants that exceeded the natural diameter of the breast, increases the chance of undesirable side effects, complication rates, and the need for revision surgery. Different plastic surgeons will have different opinions about when inappropriate time is to do revision surgery or implant exchange. Internal scar tissue will develop after the procedure and scar tissue takes a certain amount of time to become mature. Through immature scar tissue is undesirable. This means doing revision surgery. Should either be done before scar tissue was created or after scar tissue is allowed to mature. Again, each provider will have their own view on what appropriate. I don’t think it’s appropriate for us to tell you what implants you should choose. That is a decision you should make with your provider. if I was to select implants for my patients, I think all of them would feel their breast were too small in the end. I found the best way to communicate desired outcomes, is to review lots of before, and after pictures with the patients. Having a clear understanding of the look for outcome, patients are hoping to achieve helps the surgeon understand what size implants to choose. Some surgeons ask the patients to make the final decision before surgery. I personally select the implants during the procedure and use temporary sizers during surgery to guide decision-making of what implants to use. I bring before, and after pictures with me to the operating room the patient has selected as their ideal come and try to match those results first using temporary sizers. Each provider will have their own way of doing this. I suggest you follow up with your provider and discuss your concerns with him or her. Best, Mats Hagstrom, MD