It is a bit of a surprise that you haven't noticed a 200 cc enhancement difference already. In my practice, we reach a mutual agreement prior to going to the OR. It is unusual that a preoperative plan with appropriate base width and dimensional analysis can't be accomplished. A priori, it sounds like you have the stature and physique to pull off the volume enhancement you are looking for - especially on a patient who has been pre-expanded with your original implant selection.

Give it a few weeks to allow your new implants some "settling time". You may just need your surgeon to reassure you!

Published on Jul 11, 2012

It is difficult for me to imagine that an increase in implant size from 315 cc's to 515 cc's gave you "next to no difference". On a percentage basis, you increased the implant size over 60% so I suspect there will be a notable difference. Many times you have some swelling in the surrounding tissues which can actually tend to mask the breast size. I would recommend that you allow everything to settle down and then look at yourself in the mirror, both at home and with your surgeon. I suspect you will see a significant change. I Hope this helps.

J. Wethe, MD

Published on Jul 11, 2012

The VISIBLE size of the breast is both real and relative. It Is composed of the mass of the implants and also of the native breasts. But the appearance is also relative to the degree to which the breasts extend beyond the belly. (If you do nothing to the breasts, but the belly decreases, the breasts will seem bigger). Additionally, 200cc's difference in a large breast will not make the same visible impact as a 200cc difference in smaller breasts. Finally, the surgeon has the right to change the plan during surgery if the original plan isn't likely to be optimal. (That's why you pay for his/her expertise).

Published on Jul 11, 2012

Thank you for your question. I'm sorry you are disappointed with your results. With a 200cc size difference you should notice a difference in size. The size difference also depends on the type of implant (saline vs silicone) and the profile comparison of the two implants. Give it some time. Your soft tissue may be tight and not reflecting the ultimate result. Take care and try to be patient.

Published on Jul 11, 2012

It is important that you discuss this with your doctor and wait to clarify what you signed up for. You may not have been eligible for a larger implant and your doctor needs to discuss this with you. You also need to wait to see the final results. Wishing you all the best.

Published on Jul 11, 2012

Thank you for your question.

I do believe that you are very early on in the healing and recovery period and that it is too premature to judge your final results, especially in size. One question that I would have for you is did you switch from saline to silicone gel implants? When switching from saline implants to silicone gel implants, surgeons will often have to increase the implant size (cc's) by at least 100-125cc for a patient to maintain the bra cup size that they had with their old saline implants. This in large part has to do with the more balloon nature of a saline implant. Additionally, changes in implant profiles (how wide they are versus how much they project) can also impact the cosmetic result and a patient's ultimate bra cup size.

Please follow up with your operating surgeon to discuss your concerns and your results thus far. Your surgeon is most qualified to evaluate your current progress and discuss what your expectations should be moving forward.

I hope you find this helpful and I wish you the best with your recovery!

Published on Jul 11, 2012

I would give it a little more time for everything to settle. It can take up to 3 months until your implants are settled and swelling has gone away. You may notice more of a difference at that point. I would also recommend talking to your surgeon about your concerns. Best wishes.

Published on Jul 11, 2012

200 cc's is a noticeable difference. If he had put in another 50cc, that would be like adding a shot of tequila, for example. Put simply, it would not make a significant difference. If you are still too small with 515cc, then you need to go up another 100cc or more.

Published on Jul 11, 2012

If the doctor gave you a card with the stated implants on the card, verify that this is actually what they put in.

Sometimes if you have a contracture and you release the contracture and the implant has more surface area to settle out, it can appear as smaller implants even though it is more volume. The difference between 515 and 575cc is miniscule, so if they truly put 515cc implants in, you should have noted a big difference. unless the 315cc you originally had were bigger or were saline and they were overfilled.

Hope this helps. I find the best way to make sure the patient gets the size they want is to do actual sizers to add to the amount. You have to have an actual number going into the case, and I make sure the patient gives me a range and which side of the range they would lean to.

Published on Jul 11, 2012

I'm sorry, but anatomic capacity frequently trumps aesthetic desires. It's hard to believe a 64% increase in volume registers as 'no difference'. Best of luck!

Published on Jul 11, 2012

Unfortunately, many plastic surgeons are reluctant, for personal reasons, to go larger. XL breast implants is my specialty, and I realize the desire for some women to go XL! I usually can increase the cup size 4-6 in one surgery. Patients should have frank discussions with their chosen plastic surgeons as to what size they want, or they will need to have further unnecessary surgeries!!

Published on Jul 11, 2012

A 200cc upgrade is quite a big difference, about one cup size. Since you are just a few days post-op, I would recommend being patient through the healing process to see how the breasts change. In most cases, they will look smaller after surgery than expected, but will eventually "drop and fluff", resulting in more projection and fullness. The difference between 515cc and 575cc is roughly 4 tablespoons, so it's not a substantial amount. You may not consider yourself a small person, but your chest wall size may be smaller than you realize, hence why your surgeon chose to use the 515cc.

Published on Jul 11, 2012

A 200cc increase should have easily increased you a cup size or more, particularly if you were moving up from a low 300cc implant. When you already have a big implant, say a 500 or 600cc implant, a 200cc increase does not make as big an impact. 10 gallons of water added to a bath tub makes a much bigger visual difference than the same 10 gallons added to a pool. I know this is a strange analogy, but I hope you understand my point. I don't think the extra 60cc's that moving to a 575cc implant would have added would have made much difference in how you look now. As for not putting in larger implants, this is the call of your plastic surgeon. We know that over time there are more problems with larger implants, particularly if they are crammed into a space/breast that really can't accommodate it. Over time, the heavier weight of larger implants will stretch out the breast and, due to pressure from the implant, thin out the breast tissue and fat between the implant and the skin. When these things occur, the aesthetic look is horrible and fixing it is extremely difficult. As a consequence, some surgeons won't put in what they feel is an oversized implant, relative to the patient, because they don't want to be blamed for how the breasts ultimately might look and know that fixing it will not be easy but will be expensive. Hopefully your surgeon explained that to you prior to surgery. The caveat is that if you are fairly large framed and already have large breasts, it takes a much bigger implant to make a visual impact than say someone that is an A cup. The downside is that the long-term consequences of a larger implant may create worse problems down the line.

Published on Jul 11, 2012

Thank you for your question. Because you are only a few days out of surgery, I would suggest that you allow your body to completely heal before evaluating the results. Be patient. Best wishes for a result you will be pleased with.

Published on Jul 11, 2012