Can I Downsize my 600cc Silicone Implants for 500cc Without a Lift?

I got implant a 3 months ago and I selected 600cc HP but changed the size before the surgery to 500cc HP, telling the doctor the most I would go for is 550cc, and DID NOT want 600cc. The doctor ended up putting 600cc HP silicone under the muscle with an inframammary incision anyway, exactly what I didnt want. I'm 5'9 and 140lbs and was an A before. The implants are rippling already and too big. Do I pay for the revision? Can I get the size I ACTUALLY asked for without a lift?!

Doctor Answers (12)

Can I Downsize my 600cc Silicone Implants for 500cc Without a Lift?

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Very difficult situation to deal with. First before and after posted photos would help. Than it can become a trust issue or a he said she said. Are there any written or witnesses to this pre operative discussion concerning your desired size? If I was in this issue I would be glad to re operate to decrease size if you paid for the new implants, only. The other fees I would absorb. Best to have a witnessed discussion with your surgeon.

Downsizing your implants - Los Angeles

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The most important element of your revision is to make you happy. Discuss your concerns with your surgeon, as downsizing may not necessarily improve your problems. There are many variables to consider including breast tissue, pocket location, capsular contracture, and implant type.

Raffy Karamanoukian Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 56 reviews

Breast augmentation revision

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It is very important to communicate your size goals with your surgeon.  In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C cup” or "fake looking" means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
I use  intraoperative sizers and place the patient in the upright position to evaluate breast size. Use of these sizers also allow me to select the press implant profile (low, moderate, moderate plus, high-profile) that would most likely achieve the patient's goals. The patient's goal pictures are hanging on the wall, and allow for direct comparison.
I have found that this system is very helpful in improving the chances of achieving the patient's goals as consistently as possible.
By the way, the most common regret after this operation, is “I wish I was bigger”.
I hope this helps.


Reducing size of implants without lift

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This question cannot be answered without before and after photos.  My guess is that your surgeon had a reason to go larger and that reason was probably to fill out loose skin.  I also am guessing that you were opposed to having a lift   All patients need to understand that they cannot dictate the needs of their tissues and therefore the proper prodedure.  The patients anatomy always comes into play when choosing size and the need for a lift.  With experience, what one gets "on the table" is usually pretty predictable but even those of us in practice for many, many years are occasionally surprised and need to modify the operation. 

Lisa L. Sowder, MD
Seattle Plastic Surgeon
5.0 out of 5 stars 52 reviews

Can I go from a 600 cc implant to a 500 cc without needing a lift.

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I think you need to give us more information in order to recieve a more meaningful answer. Pictures would also be helpful. In general when we are talking about a 600 cc implant 50 to a 100 cc would not make a big difference. I am thinking that your plastic surgeon needed to go bigger for a reason. I don't think that we have the entire story here. If you have saline or textured implants, going to silicone and smooth implants will reduce the rippling which is usually due to thin soft tissues.

Can implants be downsized without a lift?

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What is not clear is whether your breasts were a deflated A cup in volume but with a very large, loose skin envelope that needed a large implant to fill it out, or whether your skin was tighter with good tone.  If your breast skin is tighter, then I would expect that going from 600cc to 500cc after only 3 months would not be a problem.  If your skin was quite loose to begin with and is just filled out by the 600 cc , there is a chance that it would be a little looser with the smaller implant, although it would seem that the degree of this difference would not be that extreme.  It is also not clear whether these are saline implants or silicone gel implants.  If they are under the muscle, then I would expect any wrinkling to be more in the lateral and perhaps lower portion of the breast (unless the muscle was released up the sternum too far), and this wrinkling would be more of a problem with saline implants than gel, and of course more of an issue in patients with very thin tissue. You must also be warned of the risks of large and heavy implants, in terms of long term stretching and thinning of your breast tissue and skin, drop out of the implants, etc.  Without photos, it is difficult to tell whether you are one of those patients who really needs a lift (with implants) but instead is being given very large implants in an attempt to avoid a lift, or in the mistaken impression that very large implants will "left" the breast.  Oftentimes these patients will present with problems a few years down the road that may be more difficult to correct.  A second opinion may not be a bad idea.

Rippling with 600 cc silicone gel

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I am not sure what your arrangement with your surgeon was, but at the size you have a 50-100 cc difference will likely not reduce the rippling much. You can downsize but the question is what will things look like after you downsize and how small should you go.


Best Regards,


John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 24 reviews

Reducing Breast Implant Size after Breast Augmentation in Los Angeles

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It is possible to exchange your breast implants after breast augmentation in order to go smaller. usually, if you do this within a month after your initial surgery, you would most likely don't need to undergo a lift. But if you have waited long enough to allow your breast skin to stetch then you might need to get a breast lift after changing to a smaller size breast implant. If you already have ripples going to a smaller breast implant does not eliminate ripples. In that case you would most likely need to also have a breast lift in order to tighten up your skin.

S. Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 33 reviews

Please attach pictures

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I wonder what would have been the reason for going bigger? You should ask that question from your surgeon. I would guess that you need a lift and tour surgeon tried to go little bigger(550 and 600cc are very close) to avoid lift.

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.5 out of 5 stars 66 reviews

600 down to 500 may not help!

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We do not have pre and post op photos so we can discuss other important issues. The first is revision costs and who should pay? My policy is simple, no surgeon fee, surgical suite and anesthesia is the patient's responsibility. Depending on the surgeon's relationship with the implant provider, they may be able to help with the additional cost of the new implants. Next issue is down sizing 100 cc may NOT fix your rippling and in most cases this means you are thin and the amount of breast tissue you have is likely pretty thin. Lastly, your relationship with your surgeon is obviously strained, go have a respectful and honest exchange with him or her and fix this problem first. Good luck

Charles Virden, MD
Reno Plastic Surgeon
5.0 out of 5 stars 64 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.