Preoperative Implant Size Is Strongly Associated With Alternations of Implant Size During Secondary Breast Augmentation

Background Breast augmentation is one of the most popular cosmetic surgeries performed worldwide. In turn, there has been an increasing number of secondary breast augmentation procedures in recent years. Implant selection at secondary breast augmentation can be a challenge and is affected by a number of factors. The aim of this study was to assess the main factors affecting the decision-making process with regard to implant volume determination prior to implant exchange. Methods Women who underwent elective breast implant exchange between 2012 and 2016 were included in this study. Medical records were used to acquire implant and patient data. The patient's desires, as well as medical considerations, were taken into account during the implant selection process. Results Two hundred forty-five women with an average age of 43 years (range, 21–69 years) were included in the study. The mean time between primary augmentation and implant exchange was 10 ± 5.7 years. Overall, 192 implants (38.9%) were exchanged with larger implants, 84 implants (17%) were exchanged with smaller implants, and 218 implants (44.1%) were exchanged with implants similar to the preoperative size (±25 mL). In patients who received smaller implants, the mean reduction in implant volume was found to be 78.88 mL. Women were more likely to receive a smaller implant during implant exchange if the preoperative implant volume was larger than 367 mL (P = 0.00006). Among patients who received larger implants, no correlation was found between preoperative and postoperative implant size. A positive correlation was found between the implant age and a reduction in implant size (P = 0.036). However, no correlation was found between the patient's age and the decision to reduce or enlarge implant size upon revision. Conclusions Almost half of patients receive similarly sized implants during elective implant exchange. Among those who did decide to change their implant size, more than twice as many patients opted for a larger implant as opposed to a smaller one. Relatively large preoperative implant size and longer time since primary augmentation were associated with the selection of smaller implants during exchange. Further studies should be conducted to reinforce these results.