Breast augmentation, overfilling saline 450cc 35% with internal bra, is it too much of an overfill?

I am looking for a very round, perky, full breast implant look. I already have 350cc saline implants overfilled to 425cc, but I would like them to sit higher up and have more width and be a bit bigger. My Dr says 450cc overfilled to a 600-650cc will give me the desired look. Is it too much of an overfill? I am not worried about the implants being hard or fake looking, I'm concerned about safety of my body and the implants.

Doctor Answers 4

Attaining Beautiful and Natural Appearing Breast Augmentation Results Requires a Different Strategy!!

Hi Mia,
Think about what you are after- in your own words : higher with more width.  Many women would like these changes but are unaware that it is possible!  The technique most commonly used in this country is what the public refers to as "under the muscle" and what surgeons call "dual-plane."  This is probably the technique that was used in you because it consistently yields results that are low narrow and usually pushed to the sides with an empty space in the middle.  when a dual-plane technique is used, the muscle tends to push the implants down and out and there is  a flat superior pole.  The implants that are typically used are narrow because the muscle limits that area the implant can sit in thus high profile narrow implants are used.  
I commonly revise dual-plane breast augmentations with a technique called Cold-Subfascial Breast Augmentation Revision.  In this technique, I restore the pectoralis major muscle to its original native position and elevate the strong tissue that is on the superficial side of the muscle called fascia.  The fascia becomes a sort of support bra inside the breast that lifts and supports the implant.  The fascia is also able to support the implant near midline with a soft natural slope.
I fear that your current plan will only amplify the features you dislike about your current breasts and would think you are better off doing nothing than moving forward with a larger and firmer implant.  I hope this helps!
All the best,
Rian A. Maercks M.D.

Miami Physician
4.9 out of 5 stars 73 reviews

Overfill saline breast implants?

Thank you for the question. Although I cannot provide you with specific advice, some general thoughts regarding your questions may be helpful to you.
Saline breast implants are usually filled within a range provided by the breast implant manufacturer. Utilizing saline volumes in the upper range of the manufacturer's recommendations helps cut down on concerns such as breast implant rippling. Sometimes, patients who are looking for a certain "round, fake look" benefit from the use of overfilled saline implants.  This involves filling the saline implants past the range provided by the manufacturer.  I have found, through significant experience, that for the appropriately selected patient,  very nice outcomes can be achieved safely.  Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is: 1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
  2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “round, perky look” or "D or DD cup" etc means different things to different people and therefore prove unhelpful. Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers. I hope this (and the attached link, dedicated to larger breast augmentation surgery) helps. Best wishes for an outcome that you will be very pleased with.

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

Overfilling implants not without some risks

  • The main risks of overfilling a saline implant is rupture, scalloping (irregular shape at edges) and firmness.  Taking those risks are up to you and your surgeon.  Too big depends more on what you currently look like and your desired goal.  Another consideration is a larger implant not overfilled or a silicone implant.  It will give volume and be soft without the risk of rupture or scalloping on the sides. 
  • Dr Rodger Shortt is a plastic surgeon in Oakville.  He is the Director of the Cosmetic Surgery Training Program and an Assistant Clinical Professor at McMaster University.  He strives to provide the best possible plastic surgery results and excellent care to patients from GTA including Oakville, Toronto, Mississauga, Georgetown, Milton, Burlington and Hamilton.

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
4.9 out of 5 stars 65 reviews

Safety of going larger

In my opinion, as far as safety goes, if a 350 mL overfilled implant is safe then so is a 450 mL saline overfilled implant. The makeup of the implants are exactly the same. Larger implants can put more downward stress on the breast pocket and skin trying to hold them up. They would have a greater chance of migrating both downward and outward over time. Other than that all the other risks should be exactly the same. Good luck with your surgery.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 54 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.