Breast Implant Revision: Q&A
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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?
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27 Doctor Answers |
Asked by
Ellie26
in Jacksonville, FL
+6
This sounds possible
You have obviously spent a lot of time analyzing this. Please recall that you started out with tubular breasts, the hardest starting point for breast augmentation and one which will never allow the "perfect" result. Plus, multiple surgeries will also not ever be as good as one that went really well.
That being said, I would suggest you consider the Mentor moderate profile gel implant family of the same width as your current implant if you want to maintain the same proximity of...
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+5
Downsizing breast implants with natural result is possible
Yes, I have taken care of many patients in your situation. It is possible to downsize and get natural looking results.
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...
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+4
Of course you can downsize your implants.
It is always possible to downsize your implants, but it may not always be the right thing. In your case, you mention that you previously had 400cc anatomical breast implants but was not satisfied with the size. 450 or 500 cc moderate plus implants will not be much bigger than the 400s you had before.
Ask your surgeon to place several temporary sizers during surgery to help you achieve a nice balance and result you are seeking.
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+3
An implant SIZER used DURING surgery will show ideal implant size.
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...
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+3
You will be happy with smaller implants
The downsizing the implants are done often when the patient or plastic surgeon decides to go bigger than the limitations of the soft tissue. the size of the next implant should be decided in consultation with you plastic surgeon. there are many issues to consider including your soft tissue,chest width, nipple position ,quality of your skin, breast fold position and your expectations. You may or may not ned lift and that will depend on the position of the nipple position. In my practice I...
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+3
Downsizing can pose several problems.
I have put in large, 700 to 800 cc, implants on a few occasions and they do look somewhat "done". However , that is what those patients wanted. You say that the anatomical first pare you had looked real but just too far apart. I think this emphasizes the point that the most important dimension in breast augmentation is the diameter of the breast. A good size will fill the diameter of the natural breast on the chest wall. We also should consider the width of the sternum ( breast...
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+3
They can be downsized.
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.
+3
Yes it is possible to get the smaller breast implants
Hello Ellie
Going down to 500 cc from 700cc is something we did in our office just very recently. We added a circumareolar (or donut) mastopexy at the same time. The result is excellent and the patient is very happy. Yes, it is somewhat looser than at 700 cc, but the patient is more comfortable.
She, like you, had started with smaller implants (350 cc in her case) and worked up to 700cc. She developed a hard capsule at 700 cc, so she is much happier with smaller, softer breasts.
It could...
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+3
Downsizing implants
Revision surgeries are always more complex but you are going in the right direction. There are definitely more issues with larger implants such as tissue stretching, thinning and appearance as you mentioned. The larger the implant, the less "natural" the breasts appear. Therefore, the smaller the implant, the more of your own "natural" breast will show. With a 200cc reduction you will definitely notice a change and you will likely need a breast lift to address the loose...
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+3
May need a lift
The problem of going smaller is the excess stretched skin that you had over few years. In general if your skin is elastic, most of this skin will recoil hopefuly with no problems. You might require a lift and the extent of the lift could only be accessed by your board certified plastic surgeon.Good luck
+3
Downsizing breast implants
Thanks for the question.
Implants can increase the amount of skin you have on your breasts through tissue expansion (this same concept is used for breast reconstruction).
Downsizing your implants still leaves the expanded soft tissue envelope. Removing implants or reducing the size can lead to sagging breasts.
Most of the time a 200 cc implant size difference will need more than a circumareolar mastopexy to provide a lasting result and a good shape. The mastopexy design that can be an...
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+2
Implant downsizing
You can certainly downsize but in the knowledge that this may also require mastopexy. You have considered your needs carefully and the next step is to continue to dialogue with your plastic surgeon. Best of luck on your journey!
+2
Subfascial placement for a natural but full appearance
To create a natural appearance, nothing compares to the cold-subfascial technique in my opinion. A low profile implant is used and the special subfascial plane is used to create aprojecting natural appearing tear drop shape. Also after several surgeries you are much better off with subfascial placement for support.
All the best,
Rian A. Maercks M.D.
+2
Smaller Implants
You have provided a lot of information but in the end no surgeon can give you a guarantee of size. If you had tubular breasts, your breast shaped is already distorted and correction is not always easy. While it is possible to place smaller implants it is not always predictable how your skin envelope will do and whether a breast lift or mastopexy will be required. I find the Mentor Moderate Profile Plus implants are a good choice. At the time of surgery a sizer can be used and your...
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+2
High profile implants can look unnatural from the start.
I am not a fan of high profile implants. I think, as you do, that they look a bit unnatural. The suggestions of your surgeon seem good but I'm not sure you will need a mastopexy (lift). Also, the periareolar mastopexy is seldom a good operation. I'm not saying it's not right for you but I see it misued many times.
+2
There is nothing wrong with going down on implant size
Hello,
Down sizing breast implants sometimes requires a breast lift, but is very do-able. If you are as unhappy as you write it may be a very good idea. Have a good discussion with your surgeon on your options before you have surgery and you should be OK. Talk out what you are looking to change and "fine tune" both your surgeon's plan and your expectations, so you can both be happy with the outcome.
Best Regards,
John Di Saia MD
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+2
Downsizing your implants may lead to an improved result
Yours is an exceedingly common scenario.
Downsizing sounds like the way to go. Appropriate sized implants should be selected so that the resulting breasts fit your body well.
You may need a bresat lift (either simultaneously or as a staged procedure) to reduce the "stretched" skin and restore the shape of your breasts. MH
+2
It sounds do-able
The thing you need to understand about sizing of implants is that, in my opinion, THE most important thing is the diameter of the implant. I size the implants based on this principle. Essentially, you want fullness in all quadrants.
Additionally, as implants get larger the diameter goes up while the projection may not change, or change very little. Therefore, you should see how the various sizes of implant look on your chest wall- be sure there is nice cleavage, nice lateral fullness, nice...
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+2
450 to 500 may not be large enough
You initially were unhappy with the 400 cc implants. In my experience you must go at least 100 cc larger to see a significant difference to make surgery worth while. Since you are unhappy with 700 cc, probably in the range of 500-550 cc will work best. Pictures of breasts that you like should be shown to your surgeon to make sure both of you are on the same page. You do not give your chest size. If your 36D bra does not fit, you most likely are wearing the wrong band size.
Basically...
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+2
Smaller implants and a lift can produce natural-looking breasts
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.
+2
It really depends...
Hi there- The answer to your question is very complicated, and would depend a lot on your current examination and a good understanding of your desired appearance... The variables involved would include not just your height and weight and the dimensions of the current or planned implants, but also a very detailed understanding of the skin quantity and quality present, and the location of the implant pocket on your torso. Breast aesthetics are really quite subtle. Because secondary breast...
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+2
You will likely need more than just a peri-areolar lift
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.
+1
Getting Smaller Implants - 700cc to 500cc Feasible?
Your question touches on the important issue of what looks natural. Unfortunately, it is a non-specific term that means different things to different people. When communicating with your surgeon it is important to share specifics about what you like and do not like to make sure you are on the same page. I ask patients questions to find out what specific things they are looking for in a result to make sure we are on the same page.
"Natural" can refer to the actual shape of the breast...
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+1
Going to a smaller breast implant and having a nice breast shape is possible
Hello,
The short answer is yes. It is important to understand that simply swapping to a smaller implant will not be sufficient to achieve the ideal breast shape. The 700 cc implant has a much larger pocket than a 450 or 500cc implant will need. Depending on the pocket size and position currently your plastic surgeon will likely need to close down some of the pocket. Just make sure you know what you want to achieve, communicate that clearly with your plastic...
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+1
Smaller Breast Implants
It is very possible to downsize and get a wonderful result. Be sure to express your desires with your Board Certified Plastic Surgeon ( ASPS certified) to make sure you guys are on the same page with this decision.
+1
Downsizing
Yes, it is possible to downsize and get good results. The key is to communicate during the consultation with the surgeon your objectives. The term natural may vary so take the time to explain your goals.
+1
Of course it's feasible...
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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