Can a surgeon correct wrong-sized implants? (photo)

Question

My surgeon initially put a 110cc size difference in implants without warning me. She “fixed” it but still put a size difference of 35cc’s, and she doesn’t think it needs revised anymore but I can still see and feel a difference. She tells me no one would want to operate on a size difference this small. She initially put 405cc in R, 295 in L, now the R is 330 but I’m wanting my R to be 295cc.

Daniel Barrett, MD · Answer

Dear Caring694564,

breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.
Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.
While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.
If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Earl Stephenson, Jr., MD, DDS, MBA · Answer

Dear Caring,

Thank you for your pictures. I think your final result is fantastic! There are often small differences in breast implants and natural breasts. To chase a 35 cc difference will only  lead to potential problems.  The increase would not be noticed by the casual or intimate observer. Having said all this at the end of the day it's your body and if you want to pursue that 35 cc increase you will have to locate a surgeon that will be willing to take that on as a potential client. I believe your primary surgeon is correct. It may be difficult to find that surgeon.

Best wishes!

Earl Stephenson, Jr, MD, DDS, MBA
ESJ Aesthetics

Dana Goldberg, MD · Answer

Hello, and sorry you are experiencing continued feelings of asymmetry. It is common for surgeons to want to avoid an operation for minor differences due to the risk of creating complications. However, I have done exchanges for size differences of 25mL in the past depending on how much it bothers a patient as long as they are willing to take the chance that the symmetry may still not be perfect and accept that a larger complication (like capsular contracture or infection) may result from opening the pocket again. Sometimes even if there is a perfect size match, the shape or nipple position becomes more asymmetric, so occasionally that is why I put in two sizes. If your surgeon does not feel comfortable doing this, it's likely you will be able to find a surgeon who will accommodate your wishes.

Gary M. Horndeski, MD · Answer

Yes, a surgeon can take out the 330 cc and put in 295 cc.  It may make a minor difference.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

Yes, surgeons would be willing to perform another surgery and put in equal size implants now. Your surgeon probably doesn't want to do it again for free so is justifying it by saying no one would do the surgery based on the result being acceptable. You won't change her mind, so either find another surgeon or negotiate a reasonable rate she's willing to do for and pay her.

Camille Cash, MD · Answer

Based on the provided photos you implants both appear to be bottoming out which would require a revision to correct.  During this time you can consider adjusting the implants to the size you are wanting.  You may be a candidate for mesh to give more support to the breasts.  See a board certified plastic surgeon near you to learn more.

Connie Hiers, MD, FACS · Answer

You were not even to begin with, so you do need different sized implants. Measurements can tell if an exchange to the next lower size will be worth it or to stay this size.  If you change, go down in size in the larger breasts for you are starting to bottom out from the weight.

Mark Eberbach, MD · Answer

One can see a difference in size between your two breasts. At the same time, it appears there’s been a substantial weight change from your initial surgery.

Chasing symmetry when you have intrinsic differences in breast size is often a fools game. If your weight is finally stable, then a change in implant size might improve your symmetry,

Can a surgeon correct wrong-sized implants? (photo)

Answers (8)

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