Bigger implant - Would 500cc still fit under muscle? (photo)

Dear shirleyannegallacher,

breast implant type and sizing selection is a complicated process and requires a detailed consultation that includes a discussion of your goals, a detailed examination, and a lengthy discussion. But the decision will always start and end with the patient.
When it comes to sizing, we have all of our patients find 3 photos of their desired breast size. We ask for naked breast photos because clothing can obscure the true size (push up bras). Next, we consult with patients and go over the photos and take detailed breast measurements during a physical exam. Next, we using a sizing algorithm to determine a range of implants that will work based on the exam and the measurements.
Lastly, during the operation, we use silicone sizers in the operating room to see how the size actually looks in the breast. We sit the patient up in the operating room, while asleep of course, and compare the sizer result with their desired look photos. If it is too small, we start the process over with a slightly larger implant. We don't stop until we get the perfect match.
Of all of my breast augmentation patients, every one of them has been happy with their size due to this detailed and meticulous process. You don't want to invest time and money into a result that is either too big or too small.
You should discuss your concerns with a board-certified plastic surgeon and make sure that your surgeon understands your goals.


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

Depending on how long ago you had your current implants placed, it is probable that you could increase your implant volume from 350 to 500cc. To get a more definitive answer would require a physical examination. I would caution you regarding going this large. The added weight will place you at risk for chronic pain involving the back, neck, and shoulder areas. It would also accelerate the sagging to your breasts. Discuss these issues thoroughly with your surgeon before proceeding.

You are only 35 and looking at your 3rd set of implants. 500 cc implants will never fit under the muscle. As you can see already, your breasts are wider than the chest wall and you are developing wrinkling of the skin near the sternal region from the weight of the breasts pulling down. I would not recommend larger implants. I would recommend you consider fat transfers if you want some upper pole fullness. At this time, I do recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.