Easy to Add More Saline to the Implants?

Question

I have had my saline implants for nearly 2 weeks. I feel like one implant is bigger than the other (fuller). Is it easy for my doctor to go back in and add more saline? I wasn't impressed with the size I am; I thought I'd be bigger.

Shahram Salemy, MD, FACS · Answer

It is technically possible to add more saline to a breast implant, but there are a couple of things to consider:
1) It's important to wait a few months to allow everything to settle and heal properly before consider another operation of any kind, even just adding more saline to the implant(s)
2) Adding more saline may not necessarily get you the amount of fullness you want, and so you may need one or both implants replaced.
I would give your body some time to heal properly, let all the swelling go down, and then sit down with your surgeon and put a plan together that works for you.
Good luck,
Dr. Salemy

David Shafer, MD, FACS · Answer

First of all, you are very early post op. You will see changes over the next few weeks and months as the swelling resolves and the implants and tissues settle. The worst thing would be to rush in to more surgery before allowing time for recovery from your first surgery. Second, saline implants have a recommended fill range. So, if you want a different size, you will likely need a different implant. You have to remember that this is surgery. Even though the advances in plastic surgery and anesthesia make surgery very safe and comfortable, you are still talking about surgery and there are inherent risks that cannot be discounted. Think carefully before undergoing another operation. Good luck.

Otto Joseph Placik, MD · Answer

Discuss your concerns with your surgeon for several reasons:
1) He may have filled the implants differently to complensate for size differences in the breasts.
2) Alternatively, different breast shapes or sizes may contribute to the percieved differences in the implant.
3) A fluid collection could also be responsible.
If you are unhappy with your breast size now, they will only get smaller, once the swelling has resolved.
It is unlikely that filling your implants within their recommended range will achieve your goal of larger breasts based on my experiences with implant removal and replacement. I have found, as a general rule of thumb, that when patients desire larger implants they have typically requested implants that are 50% larger than there current size. Volumes less than this tend to generate the response: " I thought they would be larger".
For example if you currently have a 325 implant, it may be filled up to 375. Filling it beyond the recommended range results in scalloping of the implant. I would advise the patient who is requesting a larger implant to consider a 450-475 taking into account the anatomical limitations of their soft tissue envelope and base diameter of the breast.

Armando Soto, MD, FACS · Answer

Hi there-
It really is too early to make an assessment of your outcome, as the result will be evolving over the next few weeks... Try to be patient and not judge the outcome or your level of satisfaction until then.
If that time goes by and you still think you would like some adjustment, whether or not it is possible without new implants will depend on the capacity of your implants, and how much larger you would like to be.
All saline implants have a range within which the can be filled... say for example you have implants that can acceptably be filled to between 300 and 350cc... If at the time of your surgery, your surgeon filled them to 350cc, then increasing the volume of your implants would require a new implant... but if they are filled to 325cc, you may have a little "wiggle room"....
Most surgeons over-fill saline implants to prevent visibility and wrinkling, and to improve longevity, but it may be an option for you.
Be patient, then discuss your goals with your surgeon.

Steven H. Williams, MD · Answer

Thanks for the question.
 
It is too early to judge small issues with symmetry and position.  There is likely considerable swelling at the two week point.  2 months will give you a better picture of where you will be in terms of size, shape and symmetry.
Adding additional volume requires replacing the implant in most cases.  (There is a specialized implant that is more commonly used for reconstruction that has a port that you can add or remove fluid from that is remotely located from the imlpant - it is unlikely you have this implant).
I hope this helps.

Steven Wallach, MD · Answer

Although filling saline implants with more saline is relatively easy, you would need an additional surgical procedure to expose the implant and fill it up. I would wait and see how things look after a few months. You may have differential swelling that may subside.

Shain A. Cuber, MD · Answer

You need to wait a little while longer before considering doing anything. You are too early post-op. When all the swelling goes down, you will likely be even smaller than you are now, so consider the following. If only very minimal changes need to be made, then it is easy to add more saline under local. However if the implant is already fully filled or you want a lot more volume, then you may need the implants exchanged, which can also be done easily. Be sure to discuss your concerns with your plastic surgeon.

Susan E. Downey, MD · Answer

After surgery, one side always seems to heal a little faster than the other side, for unexplained reasons.  This may account for the asymmetry that you are noticing.  At about six weeks to three months,  the breasts should be closer to their final state.
I would wait  until at least three months to make a final evaluation and see how you feel about the results.  That said, if at that point you still feel like you want to be larger, only a small amount of saline can be added to an implant.  Unfortunately, to add the fluid, the implant has to be removed (which is a surgical procedure).
Since only a small amount can be added and a surgical procedure is necessary, this is a serious consideration and should not be undertaken lightly.  If you decide you want much larger breasts, then this will require new implants, which of course requires more surgery and the cost of new implants. At this point I would take a deep breath and let things settle down and hopefully as things do settle down, you will love your new breasts!

Brian J. Lee, MD · Answer

Yes, it is possible to add more saline depending on current volume and size of implants.  The manufacturer has a minimum and maximum fill volume for each size implant and these should be followed.  You may need a larger size if you desire significantly larger implants.
I also suggest you wait a while until the implants have settled and early post-operative changes have calmed before making any decisions.  It is imperative that you discuss this with your  surgeon so he/she is aware of your concerns.  Working together, you can achieve your final goal.  Good luck.

G. Gregory Gallico III, MD · Answer

Almost all women have diffferent sized breasts naturally. Implants may make your natural asymmetry more obvious. You also may have some swelling which will go away with time (4-6 weeks). However, it is also possible for your surgeon to add or subtract saline in another operation.

Easy to Add More Saline to the Implants?

Answers (13)

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