Will 800cc silicone implants be the best size for my revision? (Photo)

Question

I have had two other BA surgeries. I never developed ANY breast tissue so at 18yrs old I chose small saline 350cc-400cc implant. After kids had rippling & replaced w/ (I think) 700cc ish implant? The Docs I met with said "IF that's correct" I would be ok to go up to a 800cc silicone and look similar once healed. by looking @the pictures is 700-750cc is correct? I currently wear a 34DD/36D bra. My implants are under the muscle. Will 800cc silicone be ok on my frame? And what issues could I have?

Nelson Castillo, MD · Answer

Thank you for your question and photographs.  Based on your "goal" breasts, and comparing them to your current pictures, it looks as if you could accommodate 800cc implants.  Be sure to speak with your surgeon about capsular contracture and implant malposition risks, and consider the use of an internal "bra" that may help support your breast tissue and implants.

Alejandro Nogueira, MD · Answer

I don't see any capsular contracture, to the contrary I see downwards dislocation of right breast, aka bottoming out.Treatment is multipoint capsulorraphy and, if available, the maximum adherence implants with polyurethane coating (or any macrotextured), of anatomical shape.The size is your privilege, go for anyone that makes you happy, no risks in it.

David S. Motoki, MD · Answer

Selection of the appropriate breast implants for your body frame requires an examination. Your exact breast implant size would be difficult to determine even with an exam. When replacing your breast implants it is helpful to have the implant id card or an operation report to know the make, profile and size of the current breast implants. You did not indicate why you are having revision surgery. In some cases it would not be advisable to get larger breast implants. Potential issues related to large breast implants can include sagging and bottoming out that would require breast lifting and more revision surgery.

Jay H. Ross, MD, FACS · Answer

It's impossible to answer you question without a face to face consultation. Keep in mind when you get up to the size you want- the breast tissue, muscle and skin will stretch. Capsules are more common when you have already had one. So be careful. You know you will be having more surgery in the future.

Tom J. Pousti, MD · Answer

I am sorry to hear about the complication you are experiencing. You will find that online consultants will not be able to provide you with specific advice in regards to selection of specific breast implant size/profile. Ultimately, careful communication of your goals will be critical.
Generally speaking, the best online advice I can give to ladies who are considering revisionary breast augmentation surgery (regarding breast implant size/profile selection) is:
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 are 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 communication will be critical in determining 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 "D or DD cup” 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 ( after the use of temporary intraoperative sizers). Viewing the patient's chest wall in the upright and supine positions, with temporary sizes in place, help select the best breast implant size/profile for the specific patient.
I hope this, and the attached link (dedicated to larger breast augmentation surgery concerns), helps. Best wishes.

Will 800cc silicone implants be the best size for my revision? (Photo)

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