Ninety percent of women, when they undergo secondary breast revision surgery, will change the breast implant volume to a larger size. That doesn't mean that all women do. Ten percent of the women will actually go slightly smaller.

It is, however, very important that we try to maintain some form of proportionality of the breast to the anatomical dimension of each woman's body.
Looking at the inframammary fold, the base diameter of the breasts, shoulders, hips and ectomorphic versus endomorphic versus mesomorphic build, is very important when considering how large an implant to place.

Also, the profession of the woman and culture should be taken into consideration when changing size or volume of the bag.
We like to use high profile saline implants on exchange of previous moderate profile implants because this gives much more fullness and projection of the breasts and less rippling along the sides and, with a larger size implant, you're getting more bang for your buck.
You're getting more fullness, a more beautiful appearance of the breasts without ending up wider and you're reducing visibility along the lateral breast with the high profile saline implants.
Some women will desire to downsize and go smaller. If this is the case and there is skin laxity and they require a breast lift, which can be a vertical lift versus a formal mastopexy, do keep in mind that if you remove your implants you may require a breast lift procedure to tighten up the breasts.
Some women may desire to explant the implants all together, remove the implants and have no implants replaced. In some positions, this is okay in that if they had ample breast tissue before, they may tighten up sufficiently and not require a breast lift. In some cases, they may need a breast lift in order to regain a normal tightening of the breast.

However, in some cases if you remove the implants in a woman is who was very thin prior to surgery, a breast lift may not be possible because the blood supply to the nipple may be poor and they may end up with skin necrosis or even death of the nipple areolar complex.
This has to be discussed with a Board Certified Plastic Surgeon who has the judgment and experience to know what would be safe and the correct option for you.
Stuart A. Linder, M.D., F.A.C.S. is a Beverly Hills plastic and reconstructive surgeon specializing in breast augmentation, liposuction, tummy tuck, and more.
Dr. Linder is certified by the American Society of Plastic and Reconstructive Surgeons and is a diplomate of the American Board of Plastic Surgery.
Skin Deep Magazine
"Reasons For Reoperation:
Breast Revision Surgery"
Contributing Writer:
Dr. Stuart A. Linder,
Board Certified Plastic Surgeon
January 2006
Five Major Reasons To Switch Your Saline Implants For Silicone Gel Implants in Beverly Hills
Stuart A. Linder, M.D., F.A.C.S. Beverly Hills Breast Revision Specialist
9675 Brighton Way Suite 420 - Beverly Hills, CA 90210
Phone: (310) 275-4513 - Fax: (310) 275-4813