Melissa is not alone in being confused about what size implant to choose.  It is amazing to me how often women say that wish they were larger after having breast enlargement surgery.   This happens in spite of the fact that we tell prospective patients that many women express this desire after surgery.  To help eliminate this problem, we have patients try on “sizing” implants prior to their surgery, sometimes they try on the sizers during multiple office visits.  In spite of our best efforts, more than a few women still express regret about the size they picked and wish they were larger.  Some patients choose to act on their desires and have a second surgery to be larger.  This factor accounts for many of the women having a secondary breast enlargement surgery.  My wife attributes this occurrence to the “diamond theory.”  Once you get used to a diamond ring or earrings- it’s most often tempting to want something bigger.  The size of diamonds seem to shrink when you get used to wearing them everyday!

Here are some reasons why I think some patients may experience this size envy.  Immediately following surgery, there is a significant amount of swelling.  This fullness can often be misinterpreted as the final size.  As swelling resolves, patients may now perceive a reduction in size.  This perception can lead to a disappointment in breast size.  During the healing period, the breasts also take on a more natural appearance, which may contribute to a feeling of reduction in overall size.

Finally, women incorporate their new breast size into their body image very, very quickly.  I have many patients tell me they forget to list their surgery when asked by other physicians regarding personal history of past surgeries.  This new body image can occur as soon as six weeks following a breast augmentation procedure.  Because there are only small scars after surgery, there is little or no reminder of the actual procedure and it is often likely to be simply dismissed.

For patients that do decide to increase their implant size, replacing them with larger ones is extremely straight forward, but a waiting period is needed to assure safety of the second procedure.  Most patients have little or no pain after the replacement.  They usually have a quick recovery and are generally pleased with the results.  So, if size really matters- only you are the final judge.