Very Unhappy After Breast Augmentation? (photo)

I had BA done in 2005, round silicone, low profile, below muscle, 260cc, but I was very unhappy with the size. See 1st photo. I had it re-done 3 wks ago and told my plastic surgeoun that I wanted to go bigger, with a definite cleavage. I mentioned that I wanted to be C-Cup, but that I didn't want them to be too big & look unnatural. He did round silicone, high profile, below muscle, 325cc left & 350cc right. See 2nd photo. I am so unhappy with the size. They don't seem bigger than before.

Doctor Answers 9

Not satisfied with cleavage

If you want better cleavage then ignore the volume for the moment and look solely at the diameter.  Choose the implant with the better DIAMETER.  Can you live with that volume?  That is the ultimate question.

Talmage Raine MD FACS

Chicago Plastic Surgeon
4.6 out of 5 stars 9 reviews

65 cc Increase for a Breast Implant Revision

   In general, I do not recommend a breast augmentation revision for an increase in size unless that increase in size is 150 cc or more.  The reason for this is that 50 cc differences are hard to appreciate.  100 cc shifts may be reasonable in some women.  However, 150 cc is usually when women can appreciate a difference.

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Unhappy After Breast Augmentation

It is hard to compare the photos with fresh bruising on the recent one, but the postop does look larger, but only slightly so. 

I dislike dealing with cup size, partly because they are not universally defined, and because an individual's result is not entirely predictable. 

Many surgeons on this site feel that it takes 150-250 cc of implant for a one cup size increase. 65 and 90 cc would not be expected to give much of a change in size. 

As to cleavage, your breasts are naturally further apart than on some women. The implants are properly centered behind the nipple. If your surgeon tried to place them too medially, the nipple would appear to be on the side of the breast, an unattractive and bizarre appearance. 

If you do consider still larger implants, think at least 100 cc difference, which is probably the smallest amount to give a noticeable if modest size increase.

Thanks for your question, all the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

When sizing up it takes 100-150cc to make a difference

Sorry for your disappointment. as a rule it takes about 100 to 150cc up or down to make a visible difference when changing implant size. You are bigger, but just a bit.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Implant Exchange Post Op

In my opinion, I tell my patients when changing to larger implants to go up at least 100cc in order to truly see a difference. While I never choose the size for my patients, I do strongly encourage the 100cc or larger rule when exchanging implants. The good news is that the bigger one goes the more they weigh and the more they will sag. It appears from your photo that you will have a nice shape for years.

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

Implant exchange

You had a very small volume increase from your previous implants.  A more noticeable change may have ben what you were expecting, but then you would require larger implants.

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

Choosing Volume Of Breast Implants For Increasing Size After Exchange

Your breast implant replacement result is not a surprise. Given your goals, a volumetric change of only 65ccs one side and 90cc on the other side was bound to leave you not much different than when you started...maybe just a little fuller but no real size change. It is a lot different than one would think from picking implants for an implant size change than an initial augmentation. It always takes much more volume with indwelling implants than one would ever think. You likely needed to be up in the range of 450cc or so, almost double in size to what you had, to be a full cup difference with some semblence of cleavage.

Barry L. Eppley, MD, DMD
Indianapolis Plastic Surgeon
4.7 out of 5 stars 72 reviews

Breast Implant size

Your situation is difficult to completely assess with only the pictures, however several things appear to be going on. First you have a broad chest with your breasts placed widely apart. Augmentation cannot address the position of your breasts relative to your chest, and the further apart they are the more difficult it will be to attain the "cleavage" that you desire.

In addition the skin of your breast appears tight, particularly over the new implants. There is a limit to how much the skin will stretch. The upper part of your breast already appears to be fairly full, though this is probably partly from post op edema (swelling). 

High profile implants can help with these problems, but even here there is a limit. You may be able to make them a bit larger but at the cost of increasingly more unnatural looking breasts.

As a final point, I would add that you are only 3 weeks post op. As the edema resolves and the breast softens and returns to a more normal state, the appearance of the breast will change considerable (usually for the better). This may take several months.

Eugene J. Sidoti, Jr., MD
Scarsdale Plastic Surgeon
4.7 out of 5 stars 3 reviews

Revising implant breast size

please see previous answers on Revising implant breast size

C cups vary in volume whether you are 32 , 32  or 36

36 c cup usually requires at least 375 cc  maybe 400

 the base diameter needs to match your chest.

these look too small and too narrow of a diameter.

consider shaped implants as well

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 107 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.