Plastic Surgery
Dr. Barry Eppley

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Double Board-Certified Plastic
Surgeon Dr. Barry Eppley

Case Study – Large Breast Implant Replacements


Background: Breast implants are often perceived as one-time lifelong devices. But this is the exception and not the rule. Depending upon the age at which they were placed, breast implants are often replaced at some point in a woman’s life. (and in more rare cases even removed) They are numerous reasons for why breast implants would be replaced including device failure as well as an aesthetic desires for a change in breast size.

The desire to change breast implant size, while often believed to occur early after their initial placement, is usually much later. It often is a decade or more particularly if one has had them placed before children. The breasts will undergo changes from pregnancy and weight loss and this often leads to loss of breast tissue and a real negative change in breast size and shape.

When replacing breast implants for a size increase, it is important to remember the volumetric rule that it takes at least 25% to 33% more volume to see an external change. For example, existing 300cc implants would need to be replaced with 400cc implants to see a visible change. This is usually a 1/2 cup or so. Large increases in breast size will require a 50% or greater volumetric increase. Thus 300cc implants need to be replaced with 450cc implants for a full cup size increase.

Case Study: This 47 year-old female originally had saline breast implants placed fourteen (14) years previously. They were 300cc implants filled to 350ccs. Between her age and loss of some weight she now desired a significant size increase with the desire for a two cup size increase.

large-breast-implants-replacements-front-view-dr-barry-eppley-indianapolisUnder general anesthesia her existing areolar incisions were used to remove her saline implants. The upper and inner capsule was released to accommodate the larger implants. Ultra high profile silicone implants of 700cc size were placed.

large-breast-implants-replacement-results-oblique-view-dr-barry-eppley-indianapolislarge-breast-implants-replacement-results-side-view-dr-barry-eppley-indianapolisThe reason it takes much more implant volume than one would think is due to multiple factors. The stretch of the breast tissue and skin that now exists that was not present initially during the initial procedure is a major reason. There is also the long-standing perception of breast size which initially seemed like a dramatic change but is now well visually accomodated.

As a general rule a moderate breast size increase requires 25% to 33% more volume, a moderate increase requires 50% more volume and a dramatic change requires 100% more volume.


1) Some women over their lifetime may desire to replace their breast implants to a larger size.

2) Secondary breast implant replacements surgery has a much more rapid recovery than their initial placement.

3) To make a visible difference in breast size with implant replacement the volumetric increase is usually greater than one would think.

Dr. Barry Eppley

Indianapolis, Indiana

Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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