Can an implant swap be done under local anesthesia? (photos)

Question

I had a BA about 5 weeks ago. Healing has gone well. I wanted a very modest BA. Athough I'm happy with the surgeon's work and how natural the outlines look, I feel like I have a good idea of what they're going to look like in 6 months now as a lot of the swelling has already subsided, and they're just too big for what I think looks natural for me. I don't want to go all summer covering up my too-large-for-me new breasts. Can't they just be swapped from 300cc to 250cc under local anesthesia?

Bradley Bengtson, MD, FACS · Answer

You are extremely early following breast augmentation and have a nice result.  It will take 6-12 months before your final result is in and you will lose volume over the next 3-6 months...often times significantly.50cc's is 3 tablespoons!Be patient.  It will take 3 months for you to accommodate to your new breasts.  I have patients wait a year and then do a size change a minimum of 100ccs which is 1/2 of 1 bra cup size.All my Best!Dr B

John Michael Thomassen, MD · Answer

You can probably have it done under local anesthesia with sedation.  But you need an operating room setting to ensure a sterile field and avoid any implant contamination as they are being exchanged.  It is too bad because you have a very nice result.

Steven Goldman, MD · Answer

If a patient  wishes to change implant size but requires no other alteration of her breast aesthetics, local anesthesia can usually be used for the procedure. Sterile technique and oral prophylactic antibiotics are still used. In general we do wait approximately six months after augmentation to perform a size change, but this is not necessary in all cases depending on the patient's concerns. Discuss these issues with your doctor. Good luck. Thanks for your question.

Shlomo Widder, MD · Answer

Dear Anon,  Thanks for submitting your pictures. From observing  your pictures, you appear C cup on the right side and small C cup on the left side. Your left breast fold is higher.   This is still early on in the healing process and I would recommend to wait 3 months for the maturation process to advance. I hope that you doing religiously, the implants displacement massage.    The asymmetry might be due to fluids in the right breast and it takes 2-3 months, for the fluids to get absorbed.  Once the implants settle down and you still want your breasts smaller, it will be easier to assess the amount of implants size reduction. It will depends on your chest circumference measurement in inches. For instance,  if you are presently 34 C cup, to become 34 full B , you will have to reduce the size by 75 cc.  The procedure can be easily done under local anesthesia, though, doing it under sedation anesthesia will be more comforting to you.                 Best of luck,

Keshav Magge, MD · Answer

Thank you for your question.  Theoretically, yes, the implants could be switched under sedation anesthesia, as we have done in our practice.  However,  it is still too early to perform on someone who just had implants placed 5 weeks ago.  The breast tissue needs to form a proper response around the implant, and the tissue is still inflamed and healing.  I would recommend waiting at least 6 months before considering a revision.  Best discuss your concerns with your plastic surgeon.  All the best,

Vaishali B. Doolabh, MD, FACS · Answer

Hi 199543anon. It is too early to reoperate for many reasons. Your capsule is not fully mature ( lining of scar tissue that forms naturally around all implants), your internal tissue inflammation has not plateaued yet ( lots of cellular changes still going, collagen remodeling etc) and you may cause the external scar to look darker, thick, raised, etc from early reoperating. Nonetheless, 50 cc is not a significant reduction unless you change the projection, shape and/or diameter. If they are saline, you may be able to remove some saline, without purchasing new implants. These procedures can be done under twilight anesthesia ( sedation, pain mess and local). Have a candid discussion with your plastic surgeon about what you want and let them guide you. Consider imaging software to see what different sizes will look like. Good luck!

Chad Robbins, MD · Answer

I advise you to wait at least 6 months for the implants to settle and for you to be used to them.   Yes, you can have this done under local anesthesia but it will be uncomfortable.  Good luck to you

Steven Wallach, MD · Answer

You are still early in the healing process. They will likely change a bit with  more time. Going smaller can be performed. Local may be tough.

Kenneth R. Francis, MD, FACS · Answer

Dear 1995,The short answer to your question is yes, a simple implant exchange can be performed under local anesthesia.  The choice of downsizing your implants of course is ultimately yours, but your breasts look great and although you think the swelling has subsided, it has not.  In addition, the implants will descend, your breast tissue will compress and your skin will relax over the next 6 months giving an even more natural and smaller appearance.  Good luck!

Darryl J. Blinski, MD · Answer

YES! I offer exchanges under local anesthesia with nitrous oxide 50% + O2 50% inhaler (laughing gas) at a fee to cover costs and implants and supplies around $1,800.

Can an implant swap be done under local anesthesia? (photos)

Answers (11)

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