Can you ask for less cubic centimeters on the day of surgery if you're getting saline implants?

My surgery is coming up and I've been worried they'll be too big. I'm 5'0", 105lbs. I'm a 32A (on a good day). I want fuller breasts, but not big. My surgeon recommended 325cc (he said either 300 or 325, even 350 would be good). I chose the 325, but I've been watching videos and looking at photos from other girls with similar stats and theirs look huge! I'm a little scared. I do not want to be a D-cup. I'm curious whether I can ask for 300cc instead of 325cc the day of surgery. Advice?

ANSWERS FROM DOCTORS (6)


1 week ago by Tim Sayed MD, MBA, FACS

Better to have this conversation ahead of time. It is better to fill or overfill a saline implant based on its rated fill volume (e.g., fill a 300 to 300-325 cc) than to underfill one (e.g, fill a 325 cc to only 300). Because of this, you need to discuss ahead of time as it might impact which device would be ordered.

In my experience, patients rarely wish they had gone smaller - more likely to wish they went bigger so I tend to recommend the upper range of what the patient finds acceptable. In our practice we use both sizers and simulation software (Crisalix) to help determine implant size with a high satisfaction rate.

1 week ago by Tim Sayed MD, MBA, FACS (View Profile)

Better to have this conversation ahead of time. It is better to fill or overfill a saline implant based on its rated fill volume (e.g., fill a 300 to 300-325 cc) than to underfill one (e.g, fill a 325 cc to only 300). Because of this, you need to discuss ahead of time as it might impact which device would be ordered.

In my experience, patients rarely wish they had gone smaller - more likely to wish they went bigger so I tend to recommend the upper range of what the patient finds acceptable. In our practice we use both sizers and simulation software (Crisalix) to help determine implant size with a high satisfaction rate.


2 months ago by David J. Levens, MD

Of course. Whatever sizing decisions you have discussed with your surgeon hopefully during at least 1-2 office visits, most surgeons will have a range of sizes available the day of surgery to account for minor changes in volume up or down. Also as you know, saline implants are filled at surgery and therefore there is a bit more flexibility to adjust your final volume in the OR as compared to silicone implants which have a fixed pre filled volume.

2 months ago by David J. Levens, MD (View Profile)

Of course. Whatever sizing decisions you have discussed with your surgeon hopefully during at least 1-2 office visits, most surgeons will have a range of sizes available the day of surgery to account for minor changes in volume up or down. Also as you know, saline implants are filled at surgery and therefore there is a bit more flexibility to adjust your final volume in the OR as compared to silicone implants which have a fixed pre filled volume.


2 months ago by Charles A. Messa, III, M.D., F.A.C.S.

Thank you for your question. Saline implants have a minimal fill volume and an overfill or optimal volume based on the base fill and the manufacturer's recommended volume. You do not want to underfill saline implants. An underfilled saline breast implant has an increased chance for visible and palpable rippling and implant leakage or rupture.That being said, I would recommend either a 300 cc Mentor moderate profile saline implant filled to 325 cc, or a 325 cc implant (same style) filled to 375 cc. If you are an A-cup now, it is unlikely that the latter volume will make you a D-cup. Choose the implant that is most appropriate for your breast and soft tissue measurements--breast base width, tissue stretch, measurements from the nipple to the fold, and soft tissue thickness.

2 months ago by Charles A. Messa, III, M.D., F.A.C.S. (View Profile)

Thank you for your question. Saline implants have a minimal fill volume and an overfill or optimal volume based on the base fill and the manufacturer's recommended volume. You do not want to underfill saline implants. An underfilled saline breast implant has an increased chance for visible and palpable rippling and implant leakage or rupture.That being said, I would recommend either a 300 cc Mentor moderate profile saline implant filled to 325 cc, or a 325 cc implant (same style) filled to 375 cc. If you are an A-cup now, it is unlikely that the latter volume will make you a D-cup. Choose the implant that is most appropriate for your breast and soft tissue measurements--breast base width, tissue stretch, measurements from the nipple to the fold, and soft tissue thickness.


2 months ago by The Institute of Aesthetic Surgery

Last minute implant adjustments are possible within a certain volume range. I typically have patients select a few implants around their preferred size. This offers me some flexibility and allows me to read and react to the proverbial "audible at the line of scrimmage." Patients can have a last minute change of heart and decide to go bigger (within a certain range) and an implant will be available to accommodate them.

Additionally, there is some wiggle room with saline implants as they have a size range (i.e. the 325 cc device typically goes to 350 cc). We prefer to fill them to the maximal allotted amount in order to reduce rippling (which over time can become a weakness and lead to leakage or rupture).

Regarding your specific question, you'll likely be able to make slight adjustments at the last minute. I would also remind you that 25-50 cc is a nominal amount (about the volume of a shot glass). The difference between those volumes will be minimal.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).

2 months ago by The Institute of Aesthetic Surgery (View Profile)

Last minute implant adjustments are possible within a certain volume range. I typically have patients select a few implants around their preferred size. This offers me some flexibility and allows me to read and react to the proverbial "audible at the line of scrimmage." Patients can have a last minute change of heart and decide to go bigger (within a certain range) and an implant will be available to accommodate them.

Additionally, there is some wiggle room with saline implants as they have a size range (i.e. the 325 cc device typically goes to 350 cc). We prefer to fill them to the maximal allotted amount in order to reduce rippling (which over time can become a weakness and lead to leakage or rupture).

Regarding your specific question, you'll likely be able to make slight adjustments at the last minute. I would also remind you that 25-50 cc is a nominal amount (about the volume of a shot glass). The difference between those volumes will be minimal.

As always, discuss your concerns with a board certified plastic surgeon (ABPS).


2 months ago by Tom Pousti, M.D.

Thank you for the question. In my practice, yes, we can make changes up to the morning of surgery because I have all breast implant sizes available. However you should speak with your surgeon specifically.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “extra large” or "DD cup” or "big" etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

I hope this helps. Best wishes.
Tom Pousti MD
www.PoustiPlasticSurgery.com
619-466-8851

2 months ago by Tom Pousti, M.D. (View Profile)

Thank you for the question. In my practice, yes, we can make changes up to the morning of surgery because I have all breast implant sizes available. However you should speak with your surgeon specifically.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery (regarding breast implant size/profile selection) is:

1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.

2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals.
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “extra large” or "DD cup” or "big" etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.

3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.

I hope this helps. Best wishes.
Tom Pousti MD
www.PoustiPlasticSurgery.com
619-466-8851


2 months ago by Stephen Greenberg, MD

Thank you for your question.

Your ability to change implant selection on the day of surgery will depend upon implant stock and availability at your operating surgeon's facility. In my practice, I stock a large variety of implants of different volumes and profiles, so my patients can wait up until their day of surgery for final implant selection. Not every surgeon has this in-house implant stock, as some order specific implants for each surgical case instead. If this is how your surgeon operates, this last minute change might not be possible unless he/she has pre-ordered a 300cc implant as well.

Please call your operating surgeon's office to discuss your concerns regarding your implant selection and the flexibility (or not) of choosing a slightly smaller implant as your surgical date approaches.

2 months ago by Stephen Greenberg, MD (View Profile)

Thank you for your question.

Your ability to change implant selection on the day of surgery will depend upon implant stock and availability at your operating surgeon's facility. In my practice, I stock a large variety of implants of different volumes and profiles, so my patients can wait up until their day of surgery for final implant selection. Not every surgeon has this in-house implant stock, as some order specific implants for each surgical case instead. If this is how your surgeon operates, this last minute change might not be possible unless he/she has pre-ordered a 300cc implant as well.

Please call your operating surgeon's office to discuss your concerns regarding your implant selection and the flexibility (or not) of choosing a slightly smaller implant as your surgical date approaches.


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