I had a Breast augmentation, 32B to a 32D with 300 cc's. They just aren't quite the size and fullness I wanted. Advice? (photo)

Thank you for your question.  It is impossible to just "give you a number" on what size breast implant may work for you without seeing you in person, examining your tissues and taking a number of measurements on your frame. What a 300 cc implant looks like on one patient may be very different on another patient depending on the width of their chest, the rib cage, any pre-exisitng breast asymmetries, the size and density of their native breast tissue, etc.  I do not believe a patient should be "shopping for a number" as far as breast implant size for these reasons.  If you have already had breast augmentation and you want to be fuller, then that does require a larger implant typically.  In general, if you add 100 ccs to your current implant size (i.e. go up to a 400 cc implant), that may add a half a cup size or so to your current amount of fullness. The trade-off is that you also have more risks with larger implants when they get over 400 ccs.  Breast implants over 400 ccs are larger and heavier and wider. Larger implants can "bottom out" more commonly and lead to malposition.  The larger the implant, the more narrow the distance can become between the breasts. Not everyone has "enough space" to accommodate a larger implant even if they want one.  There simply may not be "enough space".  Sometimes, we change to a high profile style implant that allows more projection to the breasts while limiting the width or base width of the implant.  Finally, some patients can be in a borderline area that may need a breast lift and simply tightening and lifting the breast over the implant they have can improve the shape and fullness without even changing the implant.  I routinely see all of these scenarios.  My recommendation is to visit with one or several board certified plastic surgeons in your area that specialize in aesthetic breast surgery.  I hope this helps!

It is very difficult to determine the exact size and shape implant you will require to best match your ideal breast image without an examination by a board certified plastic surgeon. Not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices. This is because several measurements not to mention your breast characteristics are needed to determine the optimal implant size to obtain your goals. Without knowing these dimensions it would be difficult to make this determination. For example, the existing base width of your breast will determine, in many cases, the maximal volume per implant profile that you can accommodate. To illustrate; a 100 cc difference may make a significant difference with a narrow base width breast, but much less of a difference if you have a wide chest wall and wide breast “foot print”. Therefore, just because your friend may have a great result with let’s say a 400 cc implant to make her go from a “B” cup to a “D” cup size does not mean that you will have the same result with the same size implant. . Further simply placing implants in a bra to determine the size best for you is not always accurate as the bra often distorts the size, is dependent on the pressure the bra places plus the implant is outside your breast and not under it among other variables. Computer software morphing programs that automatically determine the best implant size can be helpful in some but not all cases (e.g. doesn’t work well in my experience with existing implants, sagging or asymmetric breasts). Using “want to be” photos however are useful if simply provided to the surgeon as I will further explain in the below link:#BtoDImplantSize

I so wish that this is something that I could help you with online, but it's not. It requires an in person exam. If you are unhappy with your results then speak with your surgeon and if you no longer trust him or her then schedule a consultation for a second opinion with another board certified plastic surgeon in your area (link below). Best, Dr. Nazarian

Thanks for your question and the photo. Keep in mind that the photo you are showing has no details (age of patient, number of pregnancies, presence of implants, size of implants, etc.) If you can somehow locate a patient that has a similar shape and volume that you did prior to your surgery and the resulting look you like after, then you and your surgeon will more easily be able to communicate. Best of Luck!

The question is impossible to answer without an exam and taking some time to understand what it is you desire. A single picture and the desire to "get exactly what I want" are not enough. Measurements and possibly and imaging session along with a discussion to better understand what you are looking for will help. It is not a one size fits all sort of thing. Every patient is individual with different needs. Take some time to see a few surgeons and find someone whom you trust.All the Best,Dr. JA. Dean Jabs M.D. Ph.D. FACSBoard Certified Plastic SurgeonBethesda MD/McLean VA