I Had 325 Cc Mentor High Profile Silicone Implants Put in 6 Mos. Ago. I Would Like a Reduction,

Breast implant exchange for size may involve a series
of complex trade-offs.In some cases, it
may actually be difficult to predict how breast tissue will interact with a
breast implant without a physical examination.Even then it can be hard to predict the final aesthetic result.Although
decreasing breast size from 325 to 275cc’s is only 50cc’s or 4 tablespoons,
this could significantly affect breast shape and breast projection.When a smaller implant is utilized, gravity
may cause the inferior breast pocket to fill preferentially resulting in loss
of upper pole breast fullness.This is
especially true when the breast pocket dimensions are large relative to the
implant base dimensions.For
these reasons, it’s important to realize that no two patients are ever exactly
alike.In some cases, downsizing
implants can result in smaller aesthetically attractive breasts.In other cases, secondary deformities may
occur which require decreasing the dimensions of the breast pocket.These decisions often need to be made in the
operating room.If
you’re considering downsizing your breast implants, it’s important to consult a
board certified plastic surgeon.This
surgeon should be able to formulate a treatment plan that addresses your unique
anatomic findings and hopefully achieves your aesthetic goals.

It is definitely possible to #downsize to smaller implants and also alter the positioning; if possible. However, decreasing is size may also require a Breast #Lift to to #tighten loose skin, better optimize the end result. Any #revision has risks of unhappy outcome or other complications. #BreastAugmentation without a #BreastLift is usually a mistake looked back on by many patients. Most breasts will look larger and more droopy.They will sag more and sooner because of the excess weight altering the longevity of the results. The shape will usually not be satisfactory and sometimes results with “Snoopy” breast or double bubble. .A #mastopexy or breast lift operation is designed to improve the shape and position of the breasts without reducing their size. It is the most suitable for #breasts which sag or droop (ptosis) as a result of development, aging, pregnancy, breast-feeding and weight loss . Some patients will experience better results to restore superior fullness if an #implant is used at the time of mastopexy; better known as #AugmentationMastopexy.With both implant types there are choices when it comes to size, shape, and profile. The criteria best to suit you will be discussed in full detail at your breast augmentation consultation. Also, the right implant for the revision is contingent on shape of body and your desired outcome.Altogether, the surgery will create an elevated, more youthful breast contour. Also, the nipple and areolae of the desired size and correct heightmay also be addressed. I prefer to use a #shortscar technique, #LollipopScar or #DonutLift” rather than the majority of surgeons in the United States that use an anchor pattern lift which involve more significant scarring.The best method and #technique for your #procedures will be discussed in greater length during your one-on-one consultation with a board-certified plastic surgeon.

You are talking about a 50 cc reduction in volume - switching from 325 high-profile to 275 cc moderate-plus profile is not a substantial change in implant diameter. You will have less breast projection with this change. Your surgeon knows what's best for you, but if you dislike the current size, a reduction to the 275 cc mod-plus implant seems reasonable to me.

Hi Kenzie44, Yes, you can downsize for sure. Downsizing less than 50 cc's is probably not going to make much difference to you, but it may with these smaller implant sizes. (A patient going from 600 to 550cc woudl see no change.) All of your other questions and concerns can really only be addressed by surgeon that sees you in person and sort out many other variables. I will tell you this:  Patients focused on a bra size often end up with outcomes they are unhappy with and don't understand why they don't look the way they thought they would.  My best advice is to be concerned with what you look like with a specified amount volume. What cup size or implant size you end up is really not as important as how happy you are with what you look like. (You have already found that out the hard way.) Show your surgeon what you are visualizing for yourself with photos of other patient's outcomes and open the lines of communication. They will be able to best advise you on the procedures needed to achieve that outcome, including type of lift, if Capsulodesis, Capsulectomy, is needed and recommendations for implant size. Make sure your surgeon is board certified plastic surgeon and has experience doing a lot of downsizing surgeries. Good luck!

Thank you for the question.

The more breast surgery I do the more I realize that there is no correlation between the size or model (profile) of implant used and resulting cup size.  This may have to do with several factors including: the amount of breast volume the patient starts with, the shape of the patient's chest wall (concave or convex), the type and model of breast implant selected (saline/silicone  and low/moderate/high profile), bra  manufacturer variance  in cup sizes, the  degree  of filling of the cup  with breast tissue,  and the subjective differences in patients perceptions of cup size. 
Much of the final “look” achieved after breast augmentation surgery  depends on several factors:


1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the  preoperative breast appearance the more likely the breast augmentation “look” will be optimal.



2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing  long-term  well-placed breast implants. I personally think that these 2 factors are more important than any others, including type (saline or silicone)  or model (low/moderate/high profile)  of implant.


3. The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.



4. The size and model of breast implant used may  make a  significant difference in the final outcome. Therefore, 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" or "top heavy" 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 breast 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 the size of your implants from 325 to 275 can be easily done.  It will require reducing the size of the pocket that contains the implant to get the best results.  The diameter of the 275cc implant is less than the diameter of a 325cc implant.  You might want to consider using a moderate plus implant.  When I do breast augmentation, I use sizers to compare the size of implants to help with the decision  of which size is the best.

 

Going from a 325cc implant to a 275cc implant will not appreciably change the outcome of the breast other than give you a slightly smaller breast. A reduction of 50 cc is not that significant of a change that any pocket work would have to be done. I don't think it is necessary to go to a different profile implant either. Going to a moderate plus implant will be slightly wider than your current implant.

I think you could have your implants changed from 325cc to 275cc without creating a problem.  I would definitely recommend using a smooth silicone implant, but I agree that the difference in diameters between the two implants volumes is not that great and should not lead to the bottoming that was described.

There is no absolute criterion to correlate a specific reduction in implant volume with need for pocket modification.

While the difference in diameter is small, the volume difference also plays a role in the shaping of the breast, position of the implant and nipple orientation (think 3-dimensionally!).

Your surgeon is right to caution you about the possible change in nipple orientation, and the possible need or desirability for pocket adjustment with a smaller implant.