I agree that 20 cc.s is relatively insignificant. If a patient is contemplating going smaller, then I usually suggest going down at least two sizes within the same model style to make it worthwhile and noticeable. However, your surgeon should analyze why you think the implants are too big. Is the the width of the breast? Is it the projection? Are they very close together? Do they cause fullness superiorly? Once you analyze your breast and why you feel they do not fit your idea of what would be attractive, then changes in the style, width, height and projection of the implant may be in order. These changes will dictate a volume. It is possible that you might need to go with a narrower implant, but higher profile, with little change in the absolute volume.