Replacing Breast Implants Using Same Breast Pocket?

depending on the magnitude of the size change,a smaller implant will roll all around the pocket and might be more prone to rippling as well. The overlying tissues may also "sag" due to less structural support from the smaller device and can be improved with a lift.. The pocket needs to be changed or altered with sutures to keep the defvice in the right position.

When placing a smaller implant, with few exceptions, we repair the old pocket. While the pocket may accommodate to the new smaller implant, the bottom and sides of the pocket are usually too low and too laterally placed for the new implant, resulting in a bottomed out appearance.
Pocket repairs are technically difficult and the repair process imperfect. However, experience and conservatism combined with realistic expectations and patient cooperation with the delicate healing period typically yield very nice results.

Of course your surgeon should have discussed this with you, but I have found that the pocket will most often adapt to smaller implants. I usually use suction drains to help with this. Ocaasionally it is necessary to use internal stitches, called a capsulloraphy, to reduce the pocket in specific ways, such as raising the bottom fold or along the outside in order to make sure the space between the breasts remains the same with smaller diamter implants. This is a separate question though from what happens to the rest of the breast. A lift is sometimes required.

Hello,
Unfortunately, implant pockets do not shrink themselves very much when a larger implant is removed and replaced with a smaller one. At surgery sometimes we will perform lift surgery to take up the "slack." This is a judgment call.

Once your tissues have stretched to accomodate the larger implant, we cannot count on the pocket shrinking or retracting much with a smaller implant. It is not uncommon for there to be a need for a breast lift procedure to be done when you change to a smaller implant to avoid the smaller implant sitting lower in the stretched breast envelope.
Dr Edwards

Breast implants are replaced for any number of reasons, sometimes for size change, more often later as the implant has worn and begun to leak. If the capsule is in good condition and has the right shape, replacement into the same pocket works very well, and the submuscular location of your implant is ideal.
There are several schools of thought concerning the pocket size in augmentation. Some believe that the pocket should be larger than the implant to keep the implant soft. Massages are designed to allow displacement of the implant within the pocket, usually upward. Others believe including myself that the implant should fit the breast well, be centered on the nipple and should hug the tissue and feel as one. The capsule should fit the implant.
It can be difficult to predict what the capsule will do in response to a smaller implant. It may fit just fine, it may shrink up a bit to fit, or it may not change at all. If the capsule is too large it can be reduced at the time. This need can be predicted by the displacement I find the most objectionable, a fall or sliding of the implant to the side when on your back. A low pocket is not very nice either and can be corrected as well as the size of the implant is reduced. Your surgeon should be able to anticipate and find the best fit. Don't let this discourage you from changing to a implant that is right for you.
Best of luck,
peterejohnsonmd