Change of implants - what will the difference from 470cc HP to 620cc be like? (Photo)

Question

I had a breast implants 10months ago, from old saline implants 290cc to Mentor siltex hp 470cc. I'm so disappointed, looks the same but a bit more on the top not the change I wanted. Now I will redo them and looking for 620cc. The doctor says I can't go though I'm very slim ( 12 over breast ). My skin is thin, I'm 175cm weight 63kg. I wish my breast to have a bit sideboob otherwise I feel like the breast is sitting just on my breast. Will the difference from 470cc hp to 620cc be any different?

Daniel Barrett, MD · Answer

Dear Helpful182370,
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, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gary M. Horndeski, MD · Answer

At size 32 or 34, each 100 cc of implant corresponds to 1 cup size change. At size 36 or 38, each 200 cc of implant corresponds to 1 cup size change. From this, you can determine the size required to achieve your desired goal. You may want to consider fat transfers to the upper portion of the breast. You may also benefit from a circumareola lift to correct the nipple-areola position.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Ronald J. Edelson, MD · Answer

I think you have a very nice result and would not recommend you go any larger. Larger implants have problems if their own. Don’t look for additional problems like sagging

Connie Hiers, MD, FACS · Answer

If your surgeon says don't do them, then don't. Larger implants will stretch and thin your own tissue even more and you may not support the weight. You may bottom out or sag. Plus, they will be heavy on your neck and shoulders.

Mark Deutsch, MD, FACS · Answer

A 620 cc implant may be too large for you unfortunately. Although the amount of increase in volume is the same as your last surgery, the strain on your thin breast skin is likely too much for your breast to handle and you run the risk of multiple cosmetic breast issues long term that could be very difficult to fix. It appears that you have a nice cosmetic result and my recommendation would be to keep your current size

Mats Hagstrom, MD (license on probation) · Answer

To start with in order for us to make an assessment regarding the outcome of any plastic surgery procedure we need to see a complete set of proper before and after pictures for all previous surgeries.
This includes before and after pictures from your first procedure.
It’s really important for us to know what your breast look like before the first augmentation.
 Your implants are already much wider than the natural breast diameter and in order to make room for your new implants your surgeon had open your IMF( infra mammary fold) Doing so put you at risk for having further complications with implants that bought out.
This is a potentially difficult situation to correct?
I would definitely not recommend going bigger.
There are three variables that determine breast augmentation outcomes.
The first is the patient’s candidacy for the procedure.
The second is the choice of implants in regards to size shape and type.
The third is the surgeons ability to put the implant in the correct at atomic location.
 using excessively large implants will always increase the chance of undesirable side effects, complications, and the need for revision surgery.
you look young and I’m assuming you want these implants to last a long time.
The worst thing you can do is continue having surgery and continue increasing the size of your implants.
Implant envy is very real, but going up and up and up is going to end up, causing you to have lots of surgery in the future with plenty of frustration and regret.
 this can also lead to complete implant failure where you completely lose the ability to have implants at all.
Best,
Mats Hagstrom MD

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