What is the Best Way to Approach a Silicon Implant Reduction?

At 16 I had a breast reduction. I went to a pediatric surgeon appointed by my insurance. Years later I had severe scaring and sagging. I sought out a lift to remove scars and extra skin. My Dr said I needed implants along with the lift but I was very adamant about keeping my size small. I was a 32C pre op and agreed to a small C post op. 10 months later and I am a full D cup. I never wanted to go this big and I feel that my Dr made a miscalculation. How I fix this and is my Dr responsible?

Doctor Answers 6

How to address implant size with your plastic surgeon.

Some patients are unhappy following augmentation due to the size of the implants. Usually, it's a concern that the implants are too small. In your case, it's important to have a frank discussion with your plastic surgeon as to what you are unhappy with. We all want our patients to be thrilled with their results, and you may find that your plastic surgeon has a revision policy where correction of the size is included. I recommend setting up an appointment and discussing these issues and what can be done.

Boca Raton Plastic Surgeon
5.0 out of 5 stars 25 reviews

Implant size issues

It is not unusual to add implants and a lift after breast reduction surgery.  Often times the breasts don't look as full as some patients would like after reduction procedures.  I am not sure what your doctors policies are regarding revisions and so forth. In my office, I have ALL my patients choose their size, making them responsible for this aspect of surgery. Reason being is what I think is aesthetically pleasing may be and often times is quite different than the patients.  If a patient of mine is unhappy with their size after surgery, I have them wait at least six months before having surgery and they would be responsible for certain fees associated with the second procedure.  I typically waive my surgeons fee but cost of supplies, implants and anesthesia are still the responsibility of the patients.

Jeffrey Hartog, MD
Orlando Plastic Surgeon
4.5 out of 5 stars 60 reviews

Breast Surgery Size Concerns?

Thank you for the question.

Based on your description, it sounds like you may benefit from revisionary surgery with smaller implants ( and possible further breast lifting).

As you have found,  it will be very important to communicate your size goals with your surgeon.  In my practice I find the use of goal pictures to be very helpful.  in your case you could use your own before breast-feeding pictures as the goal. I have found that the use of words such as “natural” or “C cup” or "small" or "top heavy" 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.

I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the breast implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.  

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,486 reviews

What is the Best Way to Approach a Silicon Implant Reduction?

Your issues are very difficult to advise over the internet. I recommend you see a few boarded PSSs in your area to in person advise/examine. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Breast revision

It can be very difficult to predict cup size after implants., because each bra company measures differently. Discuss your concerns with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Breast revision surgery

Thank you for your question.  I would discuss your concerns with your plastic surgeon directly.  There are some options to help you.  Your plastic surgeon will be able to direct you and give you the best option for a revision.  

Bill Kortesis, MD
Charlotte Plastic Surgeon
4.9 out of 5 stars 90 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.