An implant SIZER used DURING surgery will show ideal implant size.

George J. Beraka, MD answers: Getting smaller implants - 700cc to 500cc feasible?

Hi. Four years ago I made the stupid choice of getting 700cc (Round smooth silicone, high profile, 14.4 x 6.2cm)breast implants. I am a tall girl, 5' 81/2" and 135 lbs. I wear a 36 band bra. My current cup size is WAY to large! My breasts look extremely fake and i am very self-conscious. Before the 700cc implants I had 400 cc anatomical implants to correct tubular A cups that were also asymetrical. I felt the 400ccs were too small. The 400cc (12.5 cm x 13 cm x 4.9cm) implants were submuscular and looked very natural, they were just small on my broad frame and seemed to be 10 miles apart. I got the 700cc implants to get a cleavage. I hate the high profile, they look really fake and I wanted a natural look. I am getting a revision soon and the doctor recommended Mentor Moderate plus profile, size 450 or 500cc smooth round silicone implants. The dimension of the 450cc implants is 13.6 x 4.2, the 500cc is 14.1 x 4.3cm. I would like a small D, right now I wear a 36D but I know it's the wrong size because the bra cups fit on the breasts like a baseball cap. I just want breasts that look "real". He said he would have to do a lift (hopefully just around the areola). Do you think going from 700cc to 450 or 500cc is feasible? Can this still produce pretty breasts that look "real"? What is your experience with downsizing?


George J. Beraka, MD
9 months ago
By George J. Beraka, MD - Manhattan Plastic Surgeon

To Ellie26,

Hi!  You should definitely get smaller implants.  Some specific suggestions:

1)  Show your surgeon a picture of breasts that you think are perfect.  Then he will know what to aim for.

2)  A sizer is a temporary saline implant inserted into the breast pocket. You are then put into the sitting position  (you are still under anesthesia, of course)  and different volumes of saline are tried to see which is the largest volume that leaves you looking natural. Then the sizer is discarded, and the correct size Mentor Moderate Plus implants are used.  This step takes all the guesswork out of the process!

3)  As a preliminary guess, I would say 450 cc's would be about right.  Looking natural means avoiding too much roundness on top.  Remember, there is a built-in conflict between big and natural.  So you have to help your surgeon know where to make the compromise.  It is different for each woman.   I recommend not going too big.  Maybe the problem with your original 400 cc implants was not the size but how the pockets were made.

4)  The pockets will be too big now for smaller implants.  The pockets will probably need to be reduced with a capsulorrhaphy   (suturing some of the pocket edges).

5)  Your breasts are probably stretched out.  Don't be afraid of a lift.  You may well need a lollypop scar.  This will probably be the secret to success.   I can tell you, from long experience, that scars are much preferable to bad shape.

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More answers to “Getting smaller implants - 700cc to 500cc feasible?”

A: They can be downsized.

William B. Rosenblatt, MD
9 months ago
By William B. Rosenblatt, MD - Manhattan Plastic Surgeon

I agree with your doctor. They can be made smaller but you might need either a nipple reduction or a small pexy at the same time. Without seeing any photos, it is impossible to say. This is one of the most common problems -- patients want big then when they see what big is they want a more natural or smaller look.

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A: You will likely need more than just a peri-areolar lift

David Shafer, MD
9 months ago
By David Shafer, MD - Manhattan Plastic Surgeon

Ellie26,

As you recognize, your original implants are very large. These stretch out the skin considerably. When you down size, you need to do something about the extra skin. Most certainly you will need a mastopexy (lift) at the same time as the implant exchange. Without pictures it is hard to give you specific advice, but I have the feeling that you will need at minimum a vertical mastopexy if not an inverted T. Good luck with your surgery.

Web reference: http://www.RealPlasticSurgery.com
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A: Smaller implants and a lift can produce natural-looking breasts

Steven Wallach, MD
9 months ago
By Steven Wallach, MD - Manhattan Plastic Surgeon

Smaller implants will look more natural in most cases. It sounds like you may need a lift as well. This can produce natural looking breasts. Good luck.

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A: Of course it's feasible...

Kenneth R. Francis, MD
9 months ago
By Kenneth R. Francis, MD - Manhattan Plastic Surgeon

but you may incur a lift, as you already know.  The downsizing is no problem, however, you may want to go with a narrower based high profile implant, since the periareolar lift will narrow your base diameter and flatten your breast somewhat.  Good luck!

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