I Want to Switch 480cc Saline Implants for 650cc Silicone, Too Big?

Hi I am 5'8, 115 lbs, and currently have 480cc saline implants. I have had 2 kids since my surgery 5 years ago and am now experiencing rippling. I would like to switch to silicone in an effort to reduce the rippling and increase the size to 650cc to replace the size and fullness I lost during pregnancy and nursing. Do you think that 650cc would be too big? I met with 2 doctors who both recommended this size but it seems really large.

Doctor Answers 13

What are the options?

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Switching to silicone will improve the ripples.  You could also consider adding Alloderm or Strattice, if your tissues are very thin.  If your implants are subglandular, you might consider having the implants placed subpectorally - this will help with ripples in the cleavage area.

In terms of more superior fullness, a breast lift or fat grafting could also be considered.  

As for size - that's more of a personal decision.  But bigger implants are heavier, and eventually, something's got to give. Usually, it's the skin, which stretches out.  

Remember: you don't have to go larger to fix these issues.

Alternate to Larger Implants

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You do need to switch from saline to silicone implants to remove the rippling.  However, increasing the fullness, lost during pregnancy and nursing, can be achieved by other means than larger implants.  Often patients will benefit from internal plication of the implant capsule which results in elevating the breast and increasing cleavage. At the same time, the intrinsic breast tissue can be elevated internally as well.  It is possible that 480cc silicone implants and internal mastopexy will give you the added fullness you desire.

Best of Luck,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Increasing breast implant size and improving rippling

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Without pictures or doing a good exam, it can be difficult to answer this question.  Rippling can be a common problem with saline implants, especially someone that has thin tissue.  Also, if the implants were placed in a subglandular position rather than submuscular, more rippling can be visible.  Switching to silicone implants often can correct minimal rippling.  However, if there is more significant rippling, the switch in implant material will not work by itself.  Switching the position of the implants to a submuscular position (if not already there) can help.  Also, using another implant material (acellular dermal matrix) on top of the implant can help augment your own tissue and provide more cover to the implant.  Unfortunately, there will be added cost to that.

Switching to larger implants (especially a jump from 480 cc to 650 cc) can be detrimental especially if rippling is already present.  Already thin tissues will become even more thin from the heaviness of the implants.  Please be careful in switching to such large implants.  Make sure that you are examined by a board-certified plastic surgeon.  Good luck!

Naveen Setty, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 78 reviews

Bigger implants may not be the best solution

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Implant size and size selection are typically causes for both patient and physician anxiety.  The goal is to provide for the patient an implant size that meets their expectations.  Going from a 480 cc saline to a 650cc gel implant will add approximately 180 grams to each side.   A gel implant will help with some of the rippling problem that you are experiencing.  The problem is that your soft tissue may not support the added weight.  A photo would be helpful to understand your individual anatomy but if you are tall and thin this implant will tend to be large and look unnatural.   Discuss your goals with your plastic surgeon and understand the implications of your choices.  There are other alternatives than you may consider such as the use of an Acellular Dermal Matirx such as Strattise to support the implant and add additional thickness over the implant to mask the ripples.  

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 20 reviews

Big Breast Implants

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The answer is yes!  It is reasonable to exchange the saline for silicone to reduce the rippling.  The heavy implants will stretch your skin over time.

Dr. ES

Switching to larger implants

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Many individuals will switch from saline breast implants to silicone to improve rippling.  However, keep in mind that this switch may not completely alleviate the problem.  Based on your height (5'8) and weight (115 lbs), it sounds like you are tall and thin which means you probably don't have a lot of body fat.  What this means is that your tissues are probably less able to camouflage the implant (because they are already very thin) which means you may still have rippling even after switching to a silicone implant.  

On the same note, based on the information you have provided, it sounds like a 650cc implant would be too large for your body.  And as many of the surgeons who have responded to your question have already stated, this may actually worsen your rippling problem.  I would definitely consider discussing your options in detail with a board certified plastic surgeon.  Good luck!

Anureet K. Bajaj, MD
Oklahoma City Plastic Surgeon
5.0 out of 5 stars 21 reviews

More rippling to come probably

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If rippling is a problem switching to silicone gel can help reduce it, but going bigger will probably move you in the other direction. You need to figure out your priorities and get a few opinions first. A lift might be in order.




Best Regards,

John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon

480 to 650 implants

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Going form 480 to 650 will jsut give you heavier larger breasts with the potential for more problems with earlier relapse, more visiblity, etc..

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Is upsize from 480cc Saline to 650 Silicon Too Big?

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At your current height and weight, a 650 cc implant is quite large. Your question doesn't make clear whether this was your preference, or that it was the recommendation of the physicians you consulted. If you came in stating you wanted a 650cc Slilicone implant, many physicians will simply reflect your stated preferences. If your primary concern is visible rippling, you need to consider that a larger implant will further thin your tissues (likely yours are already quite thin hence the rippling), and will only increase your risk of visible rippling. Although you are switching to Silicone, it is a misconception that Silicone implants do not have visible rippling problems. While the risk is less with Silicone, they certainly can and do have visible rippling in patients with thin tissues. So you need to decide. Is it really important to you to get back the extra size at the risk of continued or possibly worsening your rippling problem.

Switch 480cc Saline Implants for 650cc Silicone

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For your height and weight, 650 sounds big and like the other doctors, I would be very concerned that your already thinned tissues would be even more damaged.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 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.