Surgeon doesn't want to go larger than 345cc, but I want bigger - should I ask about doing saline implants instead of silicone?

Using the breast diameter to determine implant size is faulty in my opinion. It may seem precise but it's really not. I think a350 cc implant is a very common size to use but I'm sure you could go bigger. Saline or silicone are both fine. You should read up on the difference and the pros and cons of each to make a decision.

One important reason that your surgeon has recommended that you don’t go beyond a certain size is that anything bigger will increase your risk of complications. These complications include wound separation, where the closed incisions reopen, and skin that gets too thinned out in an effort to cover the implants, which can also increase visible rippling. If you really want to go bigger, consider getting the implants in the recommended size now and then waiting to have another surgery at a later time, after tissue expansion occurs and your body is better able to handle larger implants.

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

Thank you for the question. The implant choice process requires an in-person consultation with as there are many factors to take into consideration in this process. However, you should definitely visit with your surgeon again before your surgery to discuss your concerns. You and your surgeon need to be on the same page. I hope this helped. I wish you the best of luck. Vasileios Vasilakis, MD. Fellowship-trained plastic surgeon. Houston, TX.

Dear kreyha977,
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

Thank you for sharing your question. I would advocate seeking out additional consultations to get advice on sizing as each surgeon uses different methods to help patients select sizing.

If you are unsure about your surgeon's recommendations you can visit with a few other board certified plastic surgeons to listen to varying opinions. Just be sure not to "shop" for one who will agree with you. I often use sizers during breast augmentation surgery to allow me to best help my patients achieve the look they are wanting. I've included a video I hope you find helpful.

Have a nice day! Here’s Dr. Jose Suarez hoping to answer all your doubts. If your surgeon does not want to give you more volume, it is because he considers that the volume chosen is the one that best suits your body.

Please do not go larger than your surgeon recommends. He/she has examined and measured you and knows the best range of sizes for your tissue and frame. If you go larger, you will thin and stretch your tissue more and sag more. Also, going larger with saline may show ripples more and saline are more firm. If you have little breast tissue, you will have better results with gel implants.

Hi and welcome to our forum!The complication rates of saline vs. silicone implants are similar. Without knowledge of your height, weight, or body habitus, I cannot make a determination of proper sizing. Mentor has a 400 cc high profile silicone implant with a 12.1 cm "footprint". However, it may be too large for your body. There must be an adequate amount of skin and soft tissue envelope to accommodate a larger sized implant.If unsure, seek a second opinion from a board certified plastic surgeon before your planned surgery.Best wishes...