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

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.

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.

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!