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?

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.

Reducing size of implants without lift

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 55 reviews

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

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?

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

Hello,

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

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 34 reviews

Please attach pictures

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 83 reviews

600 down to 500 may not help!

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 67 reviews

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

Dear rockrose,

I would discuss your concerns directly with your surgeon. It should be possible to downsize your implants slightly without requiring a lift, though only your surgeon can determine this.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 14 reviews

Implant revision case

Dear unhappy 600HP,

Did you have an opportunity to try on implants before the surgery? Why HP? I use HP maybe 10% of the time and I do a lot of augmentations. I feel they just have too much projection for most patients and don't sit down against the chest well enough. Unless you want the "fake" look. Also, a recent article suggested the HP implants put a lot of pressure on the breast tissue that may cause issues further down the road. If you are under 40ish and only 3 months out you should be able to swap implants to a smaller size and your skin should shrink just fine - stay in that bra post op! Consider the Moderate Plus Mentor implants. I like those alot in the vast majority of patients. Just be sure to try the implants on before surgery inside a tight tee with a shelf bra to guage what size fits your body.

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.