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Background:  Breast implant surgery is all about, of course, making breasts bigger. But patient satisfaction comes from achieving or getting close to what size the patient wants. While breast implants come in a wide range of sizes, there is no exact method of picking an implant and achieving a certain size. This is because, while the implants are consistent in size and shape, women’s chests and breasts are not. What the implant goes into has a lot to do with what it will look like after.

Most breast implant size dissatisfaction comes from still being too small, only very rarely too big. While most women would be content to live with a breast augmentation result that does not meet their ideal breast size goals, a women who would do so usually needs a much more substantial result. With implants in place and seeing what it has created provides a good guide for how much more volume is needed. Changing breast implants is about volumetric size change.

Case Study: This 29 year-old female originally had saline breast implants placed under the muscle through a lower fold incision three years previously. She was never happy with her size and felt that her breasts were not that much bigger than before surgery. She had received 350cc saline moderate plus profile implants and this gave her a breast size of a full B in her opinion. She wanted a full D cup result.

She subsequently had her implants replaced with 500cc high profile silicone gel devices, a 150cc change or 42% increase in volume. Surprisingly, this increased her size somewhat but much less than expected, making her more like a C cup. She was still not happy with the size.   

Six months later, she underwent an additional breast implant exchange procedure. She had 700cc HP silicone implants placed, another 150cc size increase or 27% volume addition. From her initial saline breast implants, she had a 100% volume increase or double her original implant size. These implants finally achieved her desired breast size and shape.

When implants are exchanged for a larger breast size, it is important to have a clear idea as to how much change is needed. It is common for patients to perceive that a 50cc or 75cc implant volume change will make a significant difference in breast size…and it won’t. That may add a little more firmness and a slightly fuller size but almost never enough to satisfy most women who are willing to undergo surgery and spend more money to do so. A 10% to 20% volume change is just not enough. Volume changes must be anywhere from a 40% to 100% change to create a modest to significant breast size enhancement.

Case Highlights:

1) Selecting the size of a breast implant to get a specific bra size is not an exact science.

2) An indwelling implant provides a guide as to how much volume increase is needed to achieve a specific breast size.

3) A visible change in outer breast appearance requires a minimum of a 30% to 40% volume increase in ccs to be worth the effort of implant exchange surgery.

Dr. Barry Eppley

Indianapolis, Indiana

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