Imagine waking up from breast implant surgery and your chest looks bigger—much bigger—than you expected. Is it post-op swelling or are the implants larger than you thought? This scenario is making the rounds on TikTok, where a viral clip implies that nine out of 10 women wake up with implants far bigger than what they agreed upon. While we can’t find any statistical data to back this claim up, we wanted to investigate. Are surgeons really upsizing implants and if so how often (and why) is it happening?
Featured Experts
- Dr. Amy Sprole is a board-certified plastic surgeon in Wichita, KS
- Dr. Elie Levine is a board-certified plastic surgeon in New York
- Dr. Ruth Hillelson is a board-certified plastic surgeon in Richmond, VA
- Dr. Robert Singer is a board-certified plastic surgeon in La Jolla, CA
Fact-Checking the Rumor Mill
La Jolla, CA plastic surgeon Robert Singer, MD, offers a clear perspective on the misconception popularized on social media. “It’s important to remember that 92 percent of women who’ve had breast augmentation at 10 years are happy they did it. What social media tends to do is amplify stories that are extreme or atypical, creating a false narrative,” he explains.
Dr. Singer also highlights that some patients may initially feel their implants are bigger due to swelling or tightness. “This creates an illusion, but it’s important to understand that the final result will be more aligned with what was planned. It’s not uncommon for patients to later say they could have even gone bigger.”
The Importance of Preoperative Sizing
According to Wichita, KS plastic surgeon Amy Sprole, MD, a thorough preoperative process is key to avoiding size-related surprises. The goal, she says, is to give patients a clear visual of their options before making any final decisions. “In my practice, we do a virtual sizing process with Crisalix software so that patients can see what their body will look like with different sizes of implants. We also use physical sizers that patients try on with a sizer bra,” explains Dr. Sprole.
Why Implant Size Can Change
Dr. Sprole acknowledges that size adjustments during breast implant surgery, though rare, can happen. “No, it isn’t common, but sometimes it is necessary. For example, if the skin is tighter than anticipated, it may be necessary to go smaller,” she says. She adds that one common occurrence is that patients who’ve had implants for decades may not always know the size of their existing implants, which can also lead to size adjustments when switching to new implants.
New York plastic surgeon Elie Levine, MD, agrees that adjustments are uncommon but emphasizes that doctors aren’t making aesthetic sizing choices without reason. “Sizing is rarely adjusted, and when it is, it’s a minimal change,” Dr. Levine notes. He also stresses the importance of a detailed preoperative consultation to ensure patient expectations align with what’s possible. “This requires the surgeon—not their staff—spending valuable time during the consultation,” he says, emphasizing the need for clear communication between the patient and surgeon.
“Modifications to the patient’s size expectation might come up, and we prepare them for that possibility,” adds Dr. Sprole. “Nonetheless, I try very hard to deliver the implant size that the patient wants.”
Avoiding Surprises Post-Surgery
While the doctors we spoke to assured us no implant size switch happens without their patient’s knowledge, the idea that patients often wake up with larger implant sizes isn’t that far fetched. It does happen from time to time. “One would expect this to be a rare phenomenon,” says Dr. Levine. “Many of my patients who seek me out to revise work done elsewhere wake up with an implant that is not even close to the size they were expecting.”
The key to avoiding this scenario is being thorough and talking through all options. Dr. Sprole advises patients to develop a range of acceptable volumes, which allows for some flexibility during the operation if necessary.
Symmetry and Natural Results
For Richmond, VA plastic surgeon Ruth Hillelson, MD, symmetry and a natural look are critical factors when choosing an implant. “The breast must suit the body build and size symmetry comes into play, especially in breast reconstruction or augmentation,” she says. “Implant sizes may need adjustments during surgery—even right versus left. That should be discussed with the patient prior to surgery. Maybe the take-home lesson from this is that both surgeon and patient should agree with the proposed outcome. In my discussions with my patients, I listen. Always listen.”
Ultimately, while it’s possible for implant sizes to change during surgery, the surgeons we interviewed agree the best advice is to be thorough in your consultations, communicate clearly with your surgeon and ensure you’re both on the same page about what’s achievable. “Find a board-certified provider, preferably cosmetic fellowship trained, who spends time really trying to understand what you are seeking from the procedure,” adds Dr. Levine.
Dr. Singer agrees. “Patients who see board-certified plastic surgeons are well-prepared before surgery. They go over their options, see visualizations, and try different sizers. When they first wake up, there’s some swelling and tightness, but these sensations go away over time, and most patients are thrilled with their results.”
