Downsizing Saline Implants from Yr 2000? (photo)

At age 24 saline, 350cc, through the nipple. A cup prior Happy with them overall, no complications. I would like contour from the side view to be more teardrop shaped. From side view there is an s-shaped ledge from my breastbone to the implant. I feel like the implants project too much. I’d like them sportier. They have started feeling very heavy & tender and it is getting worse. Would a smaller implant help both issues? Saline or silicone? Would I need a lift too? I’d like to avoid large scars.

Doctor Answers 5

Downsizing using smaller implants and Mini Ultimate Breast Lift

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Your photographs show asymmetry, your left breast is smaller and lower than the right.  You will need a circumareola approach and a lift.  I always recommend silicone gel implants since they feel and look more natural.  I recommend the retro-pectoral position.  You are an excellent candidate for a new technique called Breast Augmentation with Mini Ultimate Breast Lift.  Through a circumareola incision, implants can be placed, breast tissue moved more medial to increase cleavage and elevated to increase upper pole fullness and your areola centered.  I always prefer the smallest implant possible since they have less complications and less drooping.  A 200 cc implant may be appropriate for you combined with Mini Ultimate Breast Lift.

Best Wishes,

Gary Horndeski, M.D.

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Revision of breast augmentation

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Your photos and discussion help very much, so thank you.  It sounds like you want smaller implants.  No one can guarantee that your symptoms will improve, but certainly smaller implants should give less projection (depending on implant style, of course).  You do have some existing asymmetry, albeit mild.  And your LEFT nipple areolar complex is lower than the RIGHT.  If you went with saline implants, the asymmetry with regard to size could be improved.  Or a slightly larger implant could be placed on the LEFT, which would help symmetry.  You would need to have a lift on the LEFT if you want to make nipple height more symmetric, but based on your photos I am not advocating that at present.  As always, an in person consultation with a board certified plastic surgeon would be your best avenue when considering revision.  Best of luck to you.

Downsizing of Breast Implants?

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Thank you for the question and pictures.

Although removing your breast implants and replacing them with smaller breast implants may help you achieve a “sportier” look ( smaller and with less projection),  this breast implant exchange will not necessarily eliminate or improve the “heavy and tender” sensation you are experiencing.  Unfortunately, without direct examination, it is not possible to give you precise advice in this regard.

Breast lifting will not be necessary in your case.  It is possible, however that manipulation of your breast implant pockets (internal suture repairs) may be helpful if you choose to downsize breast implants.  Only direct examination will provide enough information for a accurate recommendation.

There are pros/cons to the use of saline versus silicone breast implants. Some general information in this regard they be helpful to you…

The type of implant used may Influence the final outcome  of the procedure, 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.

 You will do well with in-person consultation with well experienced board-certified plastic surgeons. Communicate your goals clearly and asked to see lots of examples of the plastic surgeons' previous work helping patients with similar situations.

Best wishes.

Exchanging Turn of the Century Breast Implants

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I would agree with Dr. Chappell, your best bet would be to seek out a Board Certified Plastic Surgeon for a personal consultation and examination.  There you could discuss your concerns and evaluate options for smaller implants.

Suresh Koneru, MD
San Antonio Plastic Surgeon
4.4 out of 5 stars 18 reviews

Downsizing Saline Implants from Yr 2000? (photo)

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A 12 year result looks great. If you want to exchange to a tear drop that is your decision but as for size I would stay in the same volume. 

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.