No One Can Tell I Had Any Work Done After my Breast Augmentation?

I am 3 weeks post-op. I got 300cc overfilled to 400cc saline unders (natrelle moderate profile). In my dresses I look the exact same as I did pre-op. My family and friends say they can't tell I got surgery. How is this possible? I wanted the look that the 350 testers gave me and went up 50ccs to accomodate for the implant looking smaller when placed under the muscle. I did so much research beforehand and expected a 2 cup size increase with 400ccs. I am truly upset beyond words can explain.

Doctor Answers 10

Unhappy with breast implant choice

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  You are very early in the post op period and this means that your muscles are still in the tightened phase.  The pectoralis muscle will loosen with time and with that your implant will have more impact on your bra cup.  At this point in time, you probably have some of the implant still remaining above the braline and this will come into the pocket with time.  As it does, the breast cup gets more full.  If you were very small before your surgery and tight to the chest with the muscle (this happens many times in the patient with no children and sometimes in very athletic patients), then the time period will be somewhat longer. 

  The implant that you chose is in the modest category and usually chosen by those who do not wish to have others notice  the result.  It is somewhat discouraging that you are not yet happy but you will become more and more confident as the implants settle.

  You should also remember that you were probably padding in your regular clothes so there may not be a great visual difference now.  This is a good thing for most patients.

  The final satisfaction must lie with you with your bra off and feeling the new curves in the shower or seeing them in the mirror.  I would bet that this will be a good experience for you no matter what others say with their opinions in clothes.

   You can of course always go up in size but I usually tell patients to wait at LEAST 6 months as the naturalness comes to your breast curves.  You might be VERY surprised that you chose the right implants.  If not, change them and go from there. 

  On a final note, if you go up in size, realizing that 15 cc's is a tablespoon, then you MUST consider going up at least 100 cc's.  If you consider now that your total breast volume is the implant size plus the initial breast size, then you can see that you might now be in the 500 cc range (If your original size was in the 150 cc range).  Now consider going up 50 cc's.  NO CHANGE !!!!!!!!!!!!! 

  Discuss your disatsifaction with your doctor.  I am sure that he/she will want you to be happy with the surgery giving you the confidence you want.  If not, they will make some arrangement to make sure that you are happier.  That is a good doctor/patient relationship .

  Good luck with your breast augmentation.  Happiness is ahead !!


Concerns over contour

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You might think that you chose the wrong size but give it time. Overfilling the implants to 400cc. should give you close to a two cup size increase unless you have a very wide chest.

There are several reasons that you might feel that the improvement is less than you imagined. Your chest muscles need time to relax and stretch. If you are very athletic, the muscles are going to take a longer time to do this. Sometimes the new bra might not be a good fit and you might experiment with various types, and occasionally " friends" mean well but can be say the wrong thing at the wrong time. The fact that you and your surgeon both felt that this volume would give you the appearance that you desired lead me to believe that in time you should both be happy. Give it at least 4-5 month, and keep your surgeon informed.

John Noonan, MD (retired)
Albany Plastic Surgeon

Results 3 weeks after breast augmentation

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Since your breast augmentation was just 3 weeks ago, you definitely do not have your final result yet. It's important to be patient, allow your swelling to resolve, and allow your implants to "settle". As this happens, you will slowly begin to see your final result. Keep all your follow up appointments with your plastic surgeon.

I hope that helps and wish you all the best.

400cc is certainly a noticeable increase

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400cc by itself is certainly a noticeable volume that should not go un-noticed.  Two possible reasons why a 400cc would go un-noticed is if you already had large breasts and proportionally this was not such a big increase (however you would have to have had large breasts to start with) or perhaps you wore pushup bra or other bras that added the appearance of volume to your breasts which now is being done by the implants.  It is also possible that the volume you got is not 400cc... is it possible you got less than 400?  Or perhaps you had a leak?  
What was you initial cup size?  What is your height and weight?

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 521 reviews

Breast Cup Size After Breast Surgery Not Completely Predictable

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While the average patient's change in breast size post-op is usually two breast sizes, the final result is quite variable for a number of reasons.  Pre-op simulation with computer simulation or implants in the bra is not completely accurate because it cannot completely simulate the bodies effect on the implant.  Additionally, the variability of the skin envelope, breast tissue,breast volume, muscle size, and skeletal configuration all have a significant impact.  Despite a surgeons's and patient's best efforts final postoperative size can only be estimated not gauranteed. At least one study has shown that the use of pre and postoperative photos of patients with similar breast size, height, weight and a postoperative result that the patient likes is a very useful tool in improving satisfaction with postoperative breast size.  This information is used with measurements, other simulations and patient desires to achieve the desired outcome.  I would recommend you pull up photos on a website like implantinfoof results you like and share them with your surgeon.  Good Luck!

George Bitar, MD
Fairfax Plastic Surgeon
4.6 out of 5 stars 59 reviews

No One Can Tell I Had Any Work Done

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Without photos it is hard to offer much advice, other than to have some patience and wait at least 3 months. The pectoral muscle will flatten the implants and disguise the amount of actual enlargement, until the implants "drop", an expression that means that the muscles relax to accommodate the implant. They may appear larger than now. 

If not, your option will be getting larger implants. Choosing a size is not an exact science. I have found that having patients try on implants is the most reliable tool available. There are no fixed definitions of cup size, but oft quoted is an estimate that it takes 200-225 cc for a one cup size increase. Cup sizes are different for different bands, a  C cup on a 34 is smaller than a C cup on a 36, larger than a C cup on a 32. 

Once the implant position is stable, if you wish to increase your size, the decision about implant sizemay be more difficult than the primary decision. I like to have patients do a "rice test" using raw rice in a stocking, and spending some time at home figuring out about how much volume is needed to reach your desired size. As with an implants, a somewhat larger size would be suggested. lA sports bra works well with the rice and stockings. 

Also review your pre-op and post-op photos with your surgeon.

Thanks for your question, and best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

"No change" after breast implants is actually "Not enough change."

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You and/or your surgeon were correct in adding additional volume to your chosen "tester size," but 50cc was on the low side, as was your estimate of 400cc adding two cup sizes.

I have told my patients for years (and stated many times on this site) that it takes about 250cc to equal about one cup size, so by this method, you would have added just over 1 1/2 cup sizes to whatever breast volume you started with, not 2 cup sizes! I also tell patients that they should expect that I will add between 50-100cc to whatever size they like in the sizing room. In other words, if they like a 250cc implant and are a petite woman, then I would usually add 50cc for the "below the muscle" visible difference. A woman who likes the 600cc sizers will likely require about 700cc implants (anatomy allowing) to get that same look they preferred in the sizing room. At 350cc, I would probably have used implants in the 425cc range. Although that is only 25cc more (less than an ounce) than your 400cc implants, it would have been closer to the size you want, since you are obviously too small now. This is, BTW, the most common reason for re-operation!

Perhaps you really need to reevaluate your size choice, since it appears you will require re-operation to become happy with your result. You may actually need 500cc or more to get the look you desire, and if you want a (less natural) higher, projecting "look," you may prefer moderate plus or high profile implants, depending on your breast base width and implant base diameter so as to avoid a too-wide cleavage.

No one wants to be "too big," but "truly upset beyond words" is equally bad. Please do more homework before you ask for secondary surgery, and wait at least 3 months (6 months is better). Best wishes! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 263 reviews

Not big enough

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Sizing is the most critical preoperative aspect of the assessment for surgery. You wishes need to be communicated to the surgeon and you both need to understand each others needs and surgical alternatives. Finally the choice of implant meaning the shape is important also.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon

Breast implant size

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  It seems unusual that a 400cc implant has not provided you with a significant size change.  It's possible that you were wearing heavily padded bras pre-operatively so that you had been accustomed to your look?  

Sizing methods can fall short as the implants can look very different under the tissues at the time of surgery. The shape of the selected implant can also affect your final appearance as well(mod or high profile).

It's best to wait at least 6 months to a year to  judge your final outcome and to consult with your surgeon for a possible size increase.

Pedy Ganchi, MD
Ridgewood Plastic Surgeon
4.9 out of 5 stars 98 reviews

Unhappy with size after augmentation

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I am sorry to hear that you did not get the result that you were expecting after a breast augmentation. Selecting an implant size is something that creates significant stress beforehand, and the final selection is not always what is expected. While sizing systems, testers, and computer imaging can be helpful, it can sometimes be inexact, and occasionally women wish that they went with a different size.

The best advice that I could give would be to give it some more time. Your breasts need to further heal and you need some more time to get used to the result. If after some more time, you remain dissatisfied with the size, the implants can be exchanged for a larger size. I am sure that your plastic surgeon would be happy to discuss this with you when the time is right.

For now, hang in there.

Jeff Rockmore

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.