One of the primary goals of breast augmentation is to give the patient their desired size through the selection of the implant that can achieve that goal. While there are many methods prior to surgery to help with that selection process, none are an exact method and the final implant placed in surgery is still as much of an art form as it is science. Postoperatively, some women may be ultimately disappointed with their reluctance to go bigger or they may become accustomed to their current breast size. In all of the aforementioned circumstances, a patient may desire to change their current implant size for a larger one.
One of the advantages of removing and replacing an existing breast implant is that one has a good idea of the impact a certain volume has on one’s breast size. It should therefore be easier to know how much bigger in size (volume) to go. On the one hand, this is certainly true. On the other hand, however, one can still be fooled unless one has an appreciation of incremental volume changes by percentage.
When a patient asks me to go bigger with a breast implant, I ask them how much bigger¦.by percentage. In other words, do you want to be 25%, 50%, 75% or 100% bigger. Going less than 25% bigger hardly justifies the expense of the operation so I start at that amount. To put that into perspective, let us take for example that one has a current breast implant size of 350cc. Moving up to 400ccs, while that seems a good improvement, is really only a 15% increase in size. A 100cc implant size (450cc) increase is a 25% enlargement which begins to be visible. This 100cc minimum rule of breast implant size increase in exchanges is a good one in my Indianapolis plastic surgery experience. While in larger implants, the percentage volume increase must be proportionately bigger. (e.g., 625cc from a 500cc implant) Conversely, a smaller starting implant (300cc for example) will need only 75cc to get a 25% volume increase.
It is easy to see that using the percentage volume increase method will often run contrary to what one might have otherwise selected. Going up 25 or 50ccs in breast implant size will not make much of a difference. Patient’s usually have a misunderstanding of the impact of volume change and often believe these small increases will result in much bigger changes than they actually will.
Barry L. Eppley, M.D., D.M.D.
Indianapolis, Indiana