I’m looking to get an uplift and implants. Is the risk of necrosis higher if I go for a larger implant size?

Question

My question is that I want to go quite big and bolted looking, is the risk a lot more with going to a higher cc with lift due to the possibility of circulation issues and nipple necrosis? I have spoken to about 6 surgeons one said he would do 700cc for me I’m 5’4 and 150lbs go to the gym a lot so quite toned. bra size currently is 34c i know it’s hard to tell with just a description, but I’m just concerned with the safety, if the doctor is just telling me what I want to hear to get my money?

Scott W. Vann, MD, FACS · Answer

I do a lot of augmentation lifts in one stage in my practice. Probably 90% I do in one stage. The ones I do not do in one stage are the massive lifts [usually massive weight loss patients] and those patients that want a very large implant like over 450cc. If you really want a 700cc I would really discuss with your surgeon doing a two stage procedure to greatly reduce risk and probably give a better final look even if you do not have complications since the lift can be adjusted slightly during the second stage when placing the implant.Good luck.

Ted Eisenberg, DO, FACOS, FAACS · Answer

After I measure and discuss goals with my patients, we then look at pictures of women (my patients) with similar measurements with different size breast implants. They also get to see what they would look like when the breasts have fully dropped and fluffed and in clothes. You get to see actual results and the surgeon' s experience and not a virtual idea of what can be achieved. Women tell me that this process is very helpful in determining what is right for them. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Ronald J. Edelson, MD · Answer

I would not perform a Brest lift with 700 cc implants. If you need a full lift I would do the lift first and place the implants at a second stage in you want implants that large. Otherwise the risks are greater and you won’t get as good a result

Connie Hiers, MD, FACS · Answer

The 700 cc implant is very large and heavy and usually much too large for most women, especially someone who is 5'4".  The larger the implant, the more it thins and stretches your own tissue, and the higher risk of skin necrosis. Get a size that fits your frame and tissue so you can be happy for many years.  Avoid the future problems of getting implants that are too large and heavy for your frame and tissue.

Mats Hagstrom, MD (license on probation) · Answer

There are many variables that increase the risk of orange healing complications with a mastopexy. Doing simultaneously implant, augmentation will increase the risk. Some plastic surgeons prefer and recommend doing these a staged procedures, to decrease the risk of tissue that crosses and complications.
The risk of complications is higher if the implant is placed above the muscle, and this is not recommended when done in conjunction with a mastopexy.Working with excessively large implants will also increase the risk further, especially using a wide diameter implants.
How the procedure is done, including how much undermining is done to create the implant pocket underneath the pectoralis muscle will also impact the chance of necrosis and complications. 
The overall health and age of the patient also can contribute. Any history of tobacco abuse will also potentially increase the chance of these complications.
Your best source of information is to talk to each of the plastic surgeons individually regarding their recommendations, including if this should be done as a single or staged procedure.
Best,
Mats Hagstrom, MD

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