There are several different reasons for breast implant exchange; one of the most common is to change the size of the implants. Many women will wait until they might need a breast revision for something else which will usually occur within ten years of the original breast augmentation, but some who are unhappy with their size may not want to wait.
Dr. Miguel Delgado spends a great deal of time with his patients prior to surgery in determining the correct size, so fortunately dissatisfaction with breast implant size is rarely an issue. For the few women who wished they had a different size, 90% to 95% wished they had gone larger. Usually when trying to decide between two sizes, it is advised to go with the larger of the two.
Women need to have good communication with their cosmetic plastic surgeon and trust his/her opinion when it comes to picking the right size. There are considerations for the surgeon that the patient may not understand. The surgeon wants to maintain the proportion of the breast size to the anatomical dimension of a woman’s body, taking into consideration the relation of the shoulders and hips.
There are three main body types:
1. Ectomorph –slim, more like a fashion model
2. Endomorph – pear or hourglass shape where body fat has a tendency to settle in the lower region of the body
3. Mesomorph –hips are generally the same width as the shoulder, the body is more muscular in shape and body fat is stored fairly evenly over the body
Most women are a combination of body types, so it is essential that she is evaluated by an expertly trained cosmetic plastic surgeon to determine the correct size for her breast implants. However, the wishes of the patient are definitely taken into consideration. The patient needs to understand that if she wants very large implants, she may be limited by the width of her chest. Other factors help determine the profile of the implants, such as the patient’s age and the condition of her the skin.
Different body types will accommodate different size implants; it is not a one size fits all. Bringing in pictures to the initial consultation will help the surgeon understand the patient’s goals. It is strongly advised that the patient ask to see before and after pictures of the surgeon’s actual patients.
Dr. Delgado’s main goal is patient satisfaction; fortunately he rarely has a patient dissatisfied with the choice of implants as much time is spent in helping the patient come to a decision, including doing the “rice test” which helps her visualize what the outcome will be before surgery.
Some breast augmentation patients are anxious to have a breast revision right away if they are not happy with the results. They need to understand that implants normally ride high for the first four months or more, the skin and muscle need to stretch allowing the implants to drop into the correct position. While some patients may think they are not happy with their immediate results, once the implants drop into position, they may change their mind; time must also be given for the patient to adjust to her new body image.
If the decision is to change implants for a larger size, it may be necessary to modify the implant pocket to accommodate larger implants. On the other hand, if a woman wants smaller implants, it is possible a breast lift may be required if there is some degree of skin laxity. Each situation is individual, and depending on what changes are to be made, will affect the cost of breast revision surgery. Breast revision usually is complicated and selection of a Board Certified Plastic Surgeon who specializes in breast surgery is essential.